Collection
Extracorporeal Life Support (ECMO and ECPR)
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Great laboratory numbers may be more important than CPR downtime in determining ECPR candidacy. — Juan Gurria, ECPR patient selection: identifying candidates for extracorporeal cardiopulmonary resuscitation · 2:33
Patient Selection1 item
ECPR patient selection: identifying candidates for extracorporeal cardiopulmonary resuscitation
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Explore the critical question of pediatric ECPR candidacy with Dr. Juan Gurria from Cincinnati Children's and Dr. David Rothstein from Seattle Children's Hospital. This video defines ECPR as extra corporeal cardiopulmonary resuscitation, hi
podcast3:13 · Nov 2026
Team Coordination1 item
Preparing for successful ECPR: team coordination and early activation strategies
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Discover essential strategies for successful ECPR (Extracorporeal Cardiopulmonary Resuscitation) in pediatric patients. This video, featuring Dr. Juan Gurria from Cincinnati Children's and Dr. David Rothstein from Seattle Children's, emphas
podcast2:13 · Nov 2026
Long-term vascular surveillance is recommended rather than a one-time assessment — Juan Gurria, ECMO cannulation site selection in pediatric ECPR: neck versus femoral approach · 2:06
ECMO cannulation site selection in pediatric ECPR: neck versus femoral approach
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This GlobalCastMD video features Lizzy Lee, PA-C from Cincinnati Children's, along with Drs. Juan Gurria and David Rothstein, discussing the critical decision of neck versus femoral cannulation in pediatric ECPR. They explore the nuanced fa
podcast2:46 · Nov 2026
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Preparing for successful ECPR: team coordination and early activation strategies
The most important part of a successful ECPR case often happens before the patient ever arrests.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position0:08 ↗
Simulation has been shown to have better outcomes, at least in terms of team dynamics and patient selection.
clinicalJuan Gurria0:30 ↗
ICU teams need to think every day about ECLS candidacy both electively and in the crunch.
clinicalJuan Gurria0:36 ↗
ECPR requires a multidisciplinary team of surgeons, intensivists, perfusionists, nurses, respiratory therapists, and pharmacists.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position0:41 ↗
At Cincinnati Children's Hospital, after the second dose of epinephrine during cardiac arrest, they activate ECPR and all teams mobilize.
clinicalDavid Rothstein0:52 ↗
Experienced centers often activate the ECMO team early rather than waiting until everyone agrees that the arrest is not reversible.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position0:59 ↗
One challenge during cannulation is avoiding interruptions in chest compressions.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position1:07 ↗
Every unnecessary pause in chest compressions can reduce coronary and cerebral perfusion.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position1:11 ↗
CPR coaches are key, showing cardiac output through title CO2, oxygenation, and cardiac index from compressions.
clinicalDavid Rothstein1:15 ↗
High performing ECPR teams continuously measure CPR quality and adjust in real time using physiologic feedback.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position1:25 ↗
Two attending surgeons is key for ECPR and is practiced at Cincinnati Children's.
clinicalDavid Rothstein1:34 ↗
During ECPR it is chaotic with people running around and pushing from behind, and you need to pause compressions to cannulate.
clinicalDavid Rothstein1:38 ↗
Having two attending surgeons minimizes pauses during compressions because the second attending can check the circuit and ensure the right cannula is used.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position1:46 ↗
To improve outcomes from ECPR, it is important to prepare before cardiac arrest, practice simulations, activate ECPR early, and measure CPR performance in real time.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position1:54 ↗
ECPR patient selection: identifying candidates for extracorporeal cardiopulmonary resuscitation
ECPR is extracorporeal cardiopulmonary resuscitation, which involves adding ECMO or extracorporeal life support membrane oxygenation to conventional CPR to increase outcomes.
clinicalJuan Gurria0:31 ↗
Success in ECPR can be defined as survival with a favorable neurologic outcome.
clinicalJuan Gurria0:56 ↗
ECPR doesn't replace conventional CPR; it adds temporary heart and lung support while clinicians work to treat a potentially reversible cause of arrest.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position0:45 ↗
Considerations when deciding if a patient should receive ECPR include the likelihood that they will recover, whether the underlying disease can actually be treated, equitable use of resources, and long-term follow-up.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position1:04 ↗
A child who has had CPR for 30 minutes is not automatically a poor ECPR candidate.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position1:35 ↗
ECPR candidates need to have reversible pathology because ECMO is not a destination but a bridge to try to gain more time.
clinicalDavid Rothstein1:42 ↗
ECPR is reserved for patients who still have a realistic chance of recovery if ECMO can buy enough time, not simply for the sickest patient.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position1:49 ↗
ECPR candidates have had a witnessed arrest, evidence that organs are still being perfused, and a chance that the underlying disease can be fixed.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position1:59 ↗
Not all out of hospital arrests are the same; some patients may have a dismal presentation but reasonable numbers reflecting some sort of circulation, while others may have great community response but terrible numbers.
clinicalJuan Gurria2:08 ↗
Laboratory data such as pH, potassium, and evidence of circulation provide valuable context and influence decision making just as much as the duration of CPR.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position2:21 ↗
Great laboratory numbers may be more important than CPR downtime in determining ECPR candidacy.
opinionJuan Gurria2:33 ↗
Choosing the right ECPR patient isn't about following one laboratory value or one time limit; reversible disease matters the most.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position2:46 ↗
It's important to combine physiology, clinical judgment, and preparation to identify the patients most likely to benefit from ECPR.
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position2:54 ↗
ECMO cannulation site selection in pediatric ECPR: neck versus femoral approach
There is no universally superior cannulation approach for pediatric ECPR
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position0:35 ↗
The optimal cannulation site depends on the patient's size, anatomy, clinical condition, and the expertise of the ECMO team
Host summaryLizzy Lee summarizing the discussion — not the host's own clinical position0:37 ↗
In Seattle, femoral cannulation is preferred because it stays out of the way of CPR
clinicalJuan Gurria0:44 ↗
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