AbstractOut‐of‐hospital cardiac arrest survival continues to be dismal with the only recent improvement being that of extracorporeal cardiopulmonary resuscitation (E‐CPR) or cardiopulmonary resuscitation (CPR), augmented by extracorporeal membrane oxygenation (ECMO). Minimizing time until initiation of E‐CPR is critical to improve neurologically intact survival. Bringing E‐CPR to the patient rather than requiring transport to the emergency department may increase the number of patients eligible for E‐CPR and the chances for a good outcome. We developed a out‐of‐hospital E‐CPR (P‐ECMO) program that includes the novel use of a hand‐crank and emergency medical services (EMS) providers as first assistants. Here, we report the first P‐ECMO procedure in North America for refractory ventricular fibrillation involving a 65‐year‐old male patient who was cannulated in the field within the recommended 60‐minute low‐flow window and transported to our institution where he underwent coronary stenting. Details of program design and the procedure used may allow other systems to consider implementation of a P‐ECMO program.

中文翻译：

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院外体外膜肺氧合插管治疗难治性心室颤动：一例报告


摘要：院外心脏骤停生存率仍然很低，最近唯一的改善是体外心肺复苏 (E-CPR) 或体外膜肺氧合 (ECMO) 增强的心肺复苏 (CPR)。最大限度地缩短开始 E-CPR 的时间对于提高神经系统完整的生存率至关重要。将 E-CPR 带给患者而不是需要转运到急诊科可能会增加符合 E-CPR 资格的患者数量以及获得良好结果的机会。我们开发了一个院外 E-CPR (P-ECMO) 计划，其中包括手摇曲柄的新颖使用和紧急医疗服务 (EMS) 提供者作为第一助理。在这里，我们报告了北美首例针对难治性心室颤动的 P-ECMO 手术，涉及一名 65 岁男性患者，他在建议的 60 分钟低流量窗口内进行了现场插管，并被送往我们的机构，在那里他接受了手术。冠状动脉支架置入术。程序设计和所使用程序的细节可能允许其他系统考虑实施 P-ECMO 程序。