ECPR in Cardiac Arrest Management: The Blood Goes Round and Round

Extracorporeal Cardiopulmonary Resuscitation (ECPR), once a relatively novel and rarely used intervention, is now becoming a part of management algorithms for cardiac arrest with increasing ubiquity. As more intensivists and institutions utilize extracorporeal life support, a substantial subset will begin to offer ECPR as an advanced therapy to their local population.  To prepare clinicians for this future, an understanding of ECPR and tenets of its use is essential.  Topics to be covered will include a basic overview of veno-arterial ECMO and its physiologic principles in the setting of cardiac arrest, indications and contraindications for the use of ECPR, a discussion on outcomes of ECPR vs conventional CPR, and a summary of the most recent peer-reviewed literature available on the topic of ECPR.