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ECMO in the Management of Cardiac Arrest

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ECMO in the Management of Cardiac Arrest

Extracorporeal Membrane Oxygenation (ECMO) in managing individuals experiencing
cardiac arrest has incited a contentious discourse among medical professionals. On the one hand,
critics express apprehensions over the allocation of resources, the financial implications, and
ethical considerations associated with extending life with unclear quality. This essay completely
disagrees with these opponents' views. I believe the use of ECMO can potentially preserve organ
function, increase patient survival and recovery rates, and protect the neurologic human
functions.
The goal of ECMO is to maintain organ functionality by providing temporary help to
essential organs, especially the lungs and heart. This intervention gives these organs a reprieve
and healing period while maintaining circulation and oxygenation. According to Makdisi and
Wang's (2020) research, ECMO serves as a temporary measure to provide immediate assistance
during cardiac arrest, allowing the patient to either regain normal cardiac function or obtain a
long-term ventricular assist device as an intermediate step toward cardiac transplantation. Choi et
al. (2018) conducted research that revealed the effectiveness of ECMO in reducing the strain on
the lungs and heart during cardiac arrest. ECMO reduces the risk of injury to key organs such as
the liver and kidneys by increasing oxygen delivery to these organs and surrounding tissues. The
preservation of organ function is vital in improving the chances of recovery and lowering the risk
of long-term complications in critically ill patients.
Furthermore, as it offers important life support throughout critical phases of medical
intervention, ECMO has been proven to enhance survival and recovery rates in a fraction of
patients having cardiac arrest. This medical intervention provides temporary assistance for the
circulatory and respiratory systems, allowing the underlying cause of cardiac arrest to be treated.
This device allows medical teams to effectively tackle the underlying cause of cardiac arrest
while ensuring enough oxygen delivery, improving the chances of spontaneous circulation being
restored. Finally, this event raises the likelihood of patient survival and long-term recovery
significantly. Chen et al. (2019) discovered that patients who underwent ECMO had a
considerably greater rate of survival till discharge and a better one-year survival outlook than
patients who only got traditional CPR. The researchers determined that using ECMO improves
survival rates in hospitalized patients who suffer from cardiac arrest. Furthermore, Lasa et al.
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(2020) examined the results of patients under the age of 18 who got CPR with those who
underwent ECMO-CPR. According to the data, 40% of patients who had ECMO-CPR lived until
discharge, compared to 27% of patients who received CPR. The findings of these trials show that
using ECMO is a meaningful intervention that can increase the likelihood of survival in those
who have suffered a cardiac arrest.
Finally, the use of ECMO has the potential to improve neurological outcomes in cardiac
arrest patients. During resuscitation, the goal is to ensure adequate brain oxygenation and
perfusion. The brain's oxygen supply is restricted during cardiac arrest, leading in hypoxia-
induced cerebral damage and the possibility of neurological disability. However, ECMO allows
for the temporary support of pulmonary and cardiac functions, removing the requirement for the
heart to actively pump blood. This technique promotes the circulation of oxygenated blood
throughout the entire organism. Lasa et al. (2020) planned to compare the outcomes of patients
who received cardiopulmonary resuscitation (CPR) against ECMO-CPR in their study.
According to the data, 27% of people in the ECMO-CPR group had a positive neurological
prognosis, compared to 18% in the CPR-only group. Furthermore, Cai et al. (2023) presented
additional evidence to support this assertion, revealing that early ECMO installation resulted in
considerable improvements in the prognosis of patients with brain injury following cardiac
arrest. Extracorporeal membrane oxygenation (ECMO) has been shown to successfully reduce
inflammatory reactions, oxidative stress, brain histopathological damage, cerebral metabolism,
and the production of biomarkers related to brain injury. The studies above show that using
ECMO can significantly improve the neurological outcome of cardiac arrest patients.
This essay concludes by advocating for the use of ECMO in cardiac arrest patients.
ECMO can sustain organ function, increase survival and recovery rates, and perhaps provide
neurological protection. ECMO is thus an essential component for individuals in cardiac arrest.
More study is required to maximize the potential benefits of ECMO in clinical patient care.
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References
Cai, J., Halidan Abudou, Chen, Y., Wang, H., Wang, Y., Li, W., Li, D., Niu, Y., Chen, X., Liu,
Y., Li, Y., Liu, Z., Meng, X., & Fan, H. (2023). The effects of ECMO on neurological
function recovery of critical patients: A double-edged sword. Frontiers in Medicine, 10.
https://doi.org/10.3389/fmed.2023.1117214
Chen, Y., Lin, J., Yu, H., Ko, W., Jih-Shuin Jerng, Chang, W., Chen, W., Huang, S., Chi, N.,
Wang, C., Chen, L.-C., Tsai, P., Wang, S., Hwang, J., & Lin, F. (2019). Cardiopulmonary
resuscitation with assisted extracorporeal life-support versus conventional
cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational
study and propensity analysis. The Lancet, 372(9638), 554–561.
https://doi.org/10.1016/s0140-6736(08)60958-7
Choi, J., Ik Joon Jo, Min Seob Sim, Hee Jo Song, Yeon Kwon Jeong, Song, Y.-B., Hahn, J.,
Seung Hyuk Choi, Gwon, H., Jeon, E., Sung, K., Wook Sung Kim, & Young Tak Lee.
(2018). Extracorporeal cardiopulmonary resuscitation in patients with in-hospital cardiac
arrest: A comparison with conventional cardiopulmonary resuscitation*. Critical Care
Medicine, 39(1), 1–7. https://doi.org/10.1097/ccm.0b013e3181feb339
Lasa, J. J., Rogers, R., Localio, R., Shults, J., Raymond, T. T., Gaies, M., Thiagarajan, R. R.,
Laussen, P. C., Kilbaugh, T. J., Berg, R. A., Nadkarni, V., & Topjian, A. (2020).
Extracorporeal Cardiopulmonary Resuscitation (E-CPR) During Pediatric In-Hospital
Cardiopulmonary Arrest Is Associated With Improved Survival to Discharge.
Circulation, 133(2), 165–176. https://doi.org/10.1161/circulationaha.115.016082
Makdisi, G., & Wang, I-Wen. (2020). Extra Corporeal Membrane Oxygenation (ECMO) review
of lifesaving technology. Journal of Thoracic Disease, 7(7), E166-76.
https://doi.org/10.3978/j.issn.2072-1439.2015.07.17