ISSN: 1859 - 2872
Extracorporeal cardiopulmonary resuscitation (ECPR) in refractory cardiac arrest: Organizational experience at a provincial hospital through two clinical cases
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Abstract
Introduction: Refractory cardiac arrest, a state of prolonged circulatory cessation unresponsive to standard advanced life support, presents a formidable clinical challenge with an exceedingly poor prognosis. Extracorporeal cardiopulmonary resuscitation (ECPR) is a potential life-saving solution; however, implementing this technique in provincial centers with limited resources remains challenging. We report our initial experience in developing and applying an optimized ECPR model within the practical context of Vietnam. Case report: We present two clinical cases of in-hospital refractory cardiac arrest with contrasting outcomes. Case 1 involves a 56-year-old male patient with acute myocardial infarction who had a low-flow time (from arrest to ECMO flow) of 60 minutes; the patient regained consciousness but had irreversible heart failure. Case 2 is a 32-year-old female patient with fulminant myocarditis who had a low-flow time of only 10 minutes and achieved a full recovery. These two cases illustrate the role of ECPR as a "bridge to intervention" and a "bridge to recovery," while also emphasizing the importance of system optimization. Conclusion: Successful implementation of ECPR in resource-limited centers is feasible through the development of a well-structured organizational model, multidisciplinary team training, and strict adherence to protocols aimed at minimizing intervention time.
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References
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