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Perioperative Extracorporeal Cardiopulmonary Resuscitation: The Defibrillator of the 21st Century? A Case Report

Charlesworth, Michael, FRCA, MSc; Barker, Julian M., MRCP, FRCA, FFICM; Greenhalgh, Donna, FRCA, FFICM; Ashworth, Alan D., FRCA, FFICM

doi: 10.1213/XAA.0000000000000742
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Veno-arterial-extracorporeal membrane oxygenation (ECMO) for cardiopulmonary resuscitation (ECMO-CPR) has been recommended by new resuscitation guidelines in the United Kingdom. Our recently established yet unfunded ECMO-CPR service has thus far treated 6 patients, with 3 making a good recovery. One patient suffered a catastrophic perioperative complication through glycine absorption and we are in no doubt that she would not have survived without ECMO. We argue for a pragmatic approach to funding of ECMO-CPR because observational evidence suggests superiority over traditional resuscitation and there exists major methodological and ethical barriers to randomized controlled studies. We also call for high-quality observational evidence in the perioperative setting.

From the Wythenshawe Hospital, Manchester University Hospitals, Manchester, United Kingdom.

Accepted for publication January 11, 2018.

Funding: None.

The authors declare no conflicts of interest.

Presented in part at the 2017 AAGBI Annual Congress, Liverpool, UK.

Address correspondence to Michael Charlesworth, FRCA, MSc, Health Education North West, Piccadilly Pl, Manchester, United Kingdom. Address e-mail to mda05mc@gmail.com.

© 2018 International Anesthesia Research Society
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