Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging method of cardiopulmonary resuscitation to improve outcomes from cardiac arrest. This approach targets patients with out-of-hospital cardiac arrest previously unresponsive and refractory to standard treatment, combining approximately 1 h of standard CPR followed by venoarterial extracorporeal membrane oxygenation (VA-ECMO) and coronary artery revascularization. Despite its relatively new emergence for the treatment of cardiac arrest, the approach is grounded in a vast body of preclinical and clinical data that demonstrate significantly improved survival and neurological outcomes despite unprecedented, prolonged periods of CPR. In this review, we detail the principles behind VA-ECMO–facilitated resuscitation, contemporary clinical approaches with outcomes, and address the emerging new understanding of the process of death and capability for neurological recovery.

中文翻译：

---

通过体外心肺复苏提高心脏骤停存活率：对死亡过程的洞察

体外心肺复苏 (ECPR) 是一种新兴的心肺复苏方法，可改善心脏骤停的预后。这种方法针对先前对标准治疗无反应和难治的院外心脏骤停患者，结合大约 1 小时的标准心肺复苏，然后进行静脉动脉体外膜肺氧合 (VA-ECMO) 和冠状动脉血运重建。尽管它用于治疗心脏骤停的出现相对较新，但该方法以大量临床前和临床数据为基础，这些数据表明，尽管进行了前所未有的长时间心肺复苏，但仍显着改善了存活率和神经系统结果。在这篇综述中，我们详细介绍了 VA-ECMO 辅助复苏背后的原则、当代临床方法及其结果、