Extracorporeal life-support in patients requiring CPR.

摘要

In today's Lancet, Yih-Sharng Chen and colleagues show the possible benefits of extraeorporeal life-support in adults receiving cardiopulmonary resuscitation (CPR) in hospital for more than 10 min for problems of cardiac origin. Irrespective of the advancements made in conventional CPR, median survivals to discharge after involvement of emergency medical services are only 6.4% for out-of-hospital cardiac arrest and 13.4-17.0% for in-hospital arrest. The probable causes of high mortality in cardiac arrest are: a lack of return to spontaneous circulation; re-arrest after such a lack of return because of haemodynamic instability; and late death because of multiple organ dysfunction, including hypoxic brain injury due to ischaemic or reperfusion injury.