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.

ECPR requires a multidisciplinary team of surgeons, intensivists, perfusionists, nurses, respiratory therapists, and pharmacists.

Experienced centers often activate the ECMO team early rather than waiting until everyone agrees that the arrest is not reversible.

One challenge during cannulation is avoiding interruptions in chest compressions.

Every unnecessary pause in chest compressions can reduce coronary and cerebral perfusion.

High performing ECPR teams continuously measure CPR quality and adjust in real time using physiologic feedback.

Having two attending surgeons minimizes pauses during compressions because the second attending can check the circuit and ensure the right cannula is used.

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.