
The Critical Care Commute Podcast
The Present and Future of eCPR with Dr Darryl Abrams
Mar 25, 2025
Dr. Darryl Abrams, Associate Medical Director of the Medical ECMO Program at New York-Presbyterian/Columbia University, dives into the transformative world of extracorporeal cardiopulmonary resuscitation (eCPR). He breaks down key trials like ARREST and Prague OHCA, highlighting their impact on clinical practice. The discussion covers challenges in implementing eCPR, including patient selection and ethical considerations regarding access to this advanced care. Abrams also contrasts healthcare models in the U.S. and Canada, shedding light on disparities in treatment.
29:14
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Quick takeaways
- The podcast discusses the impact of landmark trials like ARREST, Prague OHCA, and INCEPTION on the efficacy and implementation of eCPR in refractory cardiac arrest.
- Dr. Abrams highlights the importance of system design, including minimizing low-flow time and ensuring team expertise, to enhance eCPR success rates.
Deep dives
Current Landscape of eCPR
Extracorporeal cardiopulmonary resuscitation (eCPR) has gained prominence as a potential intervention for refractory cardiac arrest, driven by a series of landmark trials that defined its efficacy. The ARREST trial was one of the first to suggest significant survival benefits from eCPR, although its small sample size and single-center design raised questions about its broader applicability. The Prague OHCA trial followed, attempting to refine eCPR implementation by randomizing patients with varied cardiac arrest rhythms shortly after the onset of arrest. This trial, however, yielded mixed results, highlighting the complexities of patient selection and the importance of rapid intervention criteria in real-world settings.
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