Extracorporeal resuscitation (ECPR) at the Department of Emergency Medicine
The Department of Emergency Medicine treats between 60 and 70 patients with refractory cardiac arrest annually using ECPR
Cardiopulmonary resuscitation is as an essential first aid skill, saving countless lives worldwide from cardiac arrest every year. The basic principles of cardiopulmonary resuscitation consist of chest compressions, ventilations, and defibrillation, and did not change much over the last decades. Chances for surviving a cardiac arrest are dependent on many factors. Some of the most important factors are recognizing the cardiac arrest and calling for help, immediately starting cardiopulmonary resuscitation with high quality chest compressions, and administering early defibrillations to rapidly achieve return of spontaneous circulation.
However, in some patients, cardiopulmonary resuscitation with chest compressions, ventilation, and defibrillation fails to restore cardiac function and spontaneous circulation.
In some of these patients, extracorporeal resuscitation (ECPR) is an option – a resuscitation strategy that has been increasingly researched and established in recent years. ECPR uses a machine for extracorporeal membrane oxygenation (ECMO) to temporarily replace cardiopulmonary function with extracorporeal circulation. ECMO technology has been successfully used for many years in heart surgery, or life-threatening pulmonary and cardiac failure. The functional principle of ECMO is to drain the patient’s blood via large-bore cannulas into the ECMO machine, where the blood is oxygenated and then pumped back into the body. ECPR uses this “pumping” and “oxygenation” functions of ECMO to restore circulation and sustain oxygenation to vital organs. This temporary extracorporeal circulation allows for the stabilization of the patient, providing time to treat the underlying cause of the cardiac arrest, such as a severe myocardial infarction. However, ECPR poses major challenges for the entire team and can only be used in selected cases. A chain of favourable circumstances are required to sucessfully treat a patient with ECPR, including recognition of the cardiac arrest, immediate start of cardiopulmonary resuscitation by first responders, and time-optimized patient management by the EMS and in-hospital crews.
The Department of Emergency Medicine has been treating patients with ECPR since 1992. Today, the “Vienna ECPR Center“ treats between 60 and 70 patients with refractory cardiac arrest annually using ECPR.
Researching and optimizing the application of ECPR are central tasks of the “Vienna ECPR Research” group, particularly through collaborations with European and international ECPR centers.
Program Directors
- Dr. Ingrid Anna Maria Magnet
Tel.: +43 (0)1 40400-39535
E-Mail: ingrid.magnet@meduniwiwen.ac.at
- Dr. Michael Poppe
Tel.: +43 (0)1 40400-39535
E-Mail: michael.poppe@meduniwien.ac.at
Radiodoktor - das Ö1 Gesundheitsmagazin
Wiederbelebung - Neue Reanimationstechnik im Einsatz
Wenn das Herz plötzlich zu schlagen aufhört, muss es schnell gehen. Umgehende Erste Hilfe Maßnahmen durch Laien, die von vom professionellen Rettungsdienst weitergeführt werden, sind die Grundvoraussetzung für das Überleben der Patientinnen und Patienten. Wenn die herkömmlichen Maßnahmen - Herzdruckmassage, Defibrillation und Beatmung - nicht ausreichen, gibt es an der Universitätsklinik für Notfallmedizin der Medizinischen Universität Wien eine weitere Möglichkeit, das Leben der Betroffenen zu retten. Dort, am Wiener AKH, kommt die sogenannte extrakorporale kardiopulmonale Reanimation, kurz ECPR, zum Einsatz.
Gestaltung: Lukian Guttenbrunner
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- Episode #5
Three Shocks and Go - Episode #8
Rhythm Check Three - A2BCDE3!
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News eCPR
Vienna ECPR Team: Research meeting and 1st meeting with ECPR patients at Heurigen Wolff
On September 27, we were delighted to celebrate our first meeting with people who have been successfully resuscitated at our clinic thanks to extracorporeal resuscitation (ECPR).
In personal discussions, our former patients had the opportunity to learn more about this life-saving treatment, the ECPR method and the associated ECMO technology. However, the exchange with all those involved in the Vienna ECPR program, both from the rescue service and from the University Clinic for Emergency Medicine, was particularly valuable. The meeting offered moving and emotional moments that gave us strength, gratitude and a good portion of motivation for the future.
The ECPR program at the Department of Emergency Medicine has continued to develop over the past few years and has overcome many hurdles. This is reflected, among other things, in a steady increase in the number of patients receiving this special therapy. In 2023, we were able to treat 63 patients in refractory circulatory arrest using ECPR.
This is thanks to a dedicated team that is constantly working to improve processes and thus help even more people in this exceptional situation. The close cooperation with the Vienna Professional Rescue Service, Cardiac Surgery, Cardio-Technology and the intensive care units of the Medical University of Vienna and all partners in the ECPR program is a key to success.
Our special thanks go to Getinge and the Austrian Association for Emergency Medicine (AAEM) for their valuable support.
We are already looking forward to many more meetings with people who can be resuscitated thanks to ECPR and all employees in the Vienna ECPR program.
- Extrakorporale Reanimation: das Wiener Modell. Poppe M, Magnet I, Krammel M; Anästhesie Nachrichten (2023)
- Extracorporeal resuscitation-criteria, prerequisites, outcome: A reality check. Magnet I, Poppe M; Med Klin Intensivmed Notfmed (2022)
- Rhythm check three - A2BCDE3! - A new acronym to select eligible patients for extracorporeal cardiopulmonary resuscitation (eCPR). Mueller M, Magnet IAM, Mitteregger T, Krammel M., Poppe M; Resuscitation (2022)
- Extracorporeal cardiopulmonary resuscitation at the emergency department: A retrospective patient selection evaluation. Poppe M, Schriefl C, Steinacher A, Clodi C, Warenits AM, Nürnberger A, Hubner P, Holzer M, Horvat J, Wiedemann D, Weiser C; European Journal of Anaesthesiology (2019)
- The incidence of "load & go" out-of-hospital-cardiac arrest candidates for emergency department utilization of emergency-extracorporeal life support. A one-year review. Poppe M, Weiser C, Holzer M, Sulzgruber P, Datler P, Keferböck M, Zeiner S, Lobmeyr E, van Tulder R, Ziegler A, Glück H, Meixner M, Schrattenbacher G, Maszar H, Zajicek A, Sterz F, Schober A; Resuscitation (2015)