Perioperative extracorporeal membrane cardiopulmonary resuscitation in adults: considerations on outcomes and patient selection criteria
DOI:
https://doi.org/10.69849/enjvc294Keywords:
ECMO, Cardiopulmonary Resuscitation, Perioperative Period, Anesthesiology, PerfusionAbstract
The article addresses the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in cardiopulmonary resuscitation (ECPR), with the objective of identifying indications and contraindications, as well as discussing, in light of current evidence, its potential benefits compared with conventional cardiopulmonary resuscitation.
This is a bibliographic study conducted in accordance with the stages proposed by Creswell (2021), involving a systematic search of high-quality databases and journal platforms, including PubMed, Google Scholar, Elsevier, British Medical Journal, Anesthesiology, and Anesthesia & Analgesia. The following keywords were used: ECPR, ECLS, and ECPR in the perioperative period. The results identify indications and contraindications and discuss the potential benefits of its use. The reviewed studies suggest a potential benefit of ECPR in both out-of-hospital and in-hospital settings. However, further randomized controlled trials are still required, particularly in the in-hospital setting and more specifically during the perioperative period, to allow for a more accurate assessment of its potential benefits. A relevant factor for potentially positive outcomes is the presence of a highly controlled environment, such as an operating room with available surgical teams, which may facilitate its implementation with fewer adverse events. Additionally, the various causes of perioperative cardiac arrest may require a longer time for definitive treatment of the underlying condition. Patient selection follows the guidelines of ELSO, which are well established worldwide and serve as the primary reference for decision-making in this context.
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Copyright (c) 2026 Rodrigo dos Santos Nascimento Larsem, Vera Lucia Martins, Rafaela Mourão Redon, Rafael Rodrigues Nuñez (Autor)
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