Authors' objectives: The CEDIT (hospital based HTA agency) of AP-HP (Paris University Hospital) assessed the impact and value of extracorporeal membrane oxygenation (ECMO) used in a pre-hospital setting, for patients with refractory cardiac arrests. This assessment follows a request from an advanced life support unit from Necker Hospital to use the Cardiohelp® device (Maquet) for this purpose.

Authors' recommendations: The small number of cases published argue for the feasibility of veno-arterial ECMO performed in a pre-hospital setting, but the level of evidence is low and the feasibility has to be confirmed. There is currently no conclusive evidence of efficacy and clinical safety. The few elements of presumption existing could warrant a clinical study comparing hospital and pre-hospital ECMO. The study is to demonstrate the clinical benefit of pre-hospital ECMO and provide arguments lacking in terms of medical evidence (eg understanding of the risk of infection and ischemic consequences for the canulated limb). Given the medical, economic and organizational uncertainties, CEDIT recommends that the use of veno-arterial pre-hospital ECMO at AP-HP should only be made in the context of a clinical trial involving a cooperation between the different teams. CEDIT wishes to re-evaluate the pre-hospital use of ECMO in the light of the results of this study. The importance of the subject could justify a national assessment.

Project Status: Completed

Year Published: 2015

URL for published report: http://cedit.aphp.fr/pre-hospital-ecmo-refractory-cardiac-arrest/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Organisation Name: Cellule Innovation of the AP-HP

Copyright: Comite d´Evaluation et de Diffusion des Innovations Technologiques (CEDIT)