{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:26:14Z","timestamp":1791390374430,"version":"4.3.3"},"reference-count":71,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T00:00:00Z","timestamp":1690329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>According to the latest international resuscitation guidelines, extracorporeal cardiopulmonary resuscitation (ECPR) involves the utilization of extracorporeal membrane oxygenation (ECMO) in specific patients experiencing cardiac arrest, and it can be considered in situations where standard cardiopulmonary resuscitation efforts fail if they have a potentially reversible underlying cause, among which we can also find hypothermia. In cases of cardiac arrest, both witnessed and unwitnessed, hypothermic patients have higher chances of survival and favorable neurological outcomes compared to normothermic patients. ECPR is a multifaceted procedure that requires a proficient team, specialized equipment, and comprehensive multidisciplinary support within a healthcare system. However, it also carries the risk of severe, life-threatening complications. With the increasing use of ECPR in recent years and the growing number of centers implementing this technique outside the intensive care units, significant uncertainties persist in both prehospital and emergency department (ED) settings. Proper organization is crucial for an ECPR program in emergency settings, especially given the challenges and complexities of these treatments, which were previously not commonly used in ED. Therefore, within a narrative review, we have incorporated the initial case of ECPR in an ED in Romania, featuring a successful resuscitation in the context of severe hypothermia (20 \u00b0C) and a favorable neurological outcome (CPC score of 1).<\/jats:p>","DOI":"10.3390\/jcm12154922","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T02:07:17Z","timestamp":1690423637000},"page":"4922","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Beginning of an ECLS Center: First Successful ECPR in an Emergency Department in Romania\u2014Case-Based Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4949-8685","authenticated-orcid":false,"given":"Paul Lucian","family":"Nedelea","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Emergency Department, \u201cSt. Spiridon\u201d Emergency Clinical County Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilian","family":"Manolescu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Emergency Department, \u201cSt. Spiridon\u201d Emergency Clinical County Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adi-Ionut","family":"Ciumanghel","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Anesthesia Intensive Care Unit, \u201cSt. Spiridon\u201d Emergency Clinical County Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai","family":"Constantin","sequence":"additional","affiliation":[{"name":"2nd Internal Medicine Clinic, \u201cSt. Spiridon\u201d Emergency Clinical County Hospital, 700111 Iasi, Romania"},{"name":"Internal Medicine Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Hauta","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3994-2356","authenticated-orcid":false,"given":"Oana","family":"Sirbu","sequence":"additional","affiliation":[{"name":"2nd Internal Medicine Clinic, \u201cSt. Spiridon\u201d Emergency Clinical County Hospital, 700111 Iasi, Romania"},{"name":"Internal Medicine Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Ionescu","sequence":"additional","affiliation":[{"name":"3rd Surgery Clinic, \u201cSt. Spiridon\u201d Emergency Clinical County Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Blaj","sequence":"additional","affiliation":[{"name":"Anesthesia Intensive Care Unit, \u201cSt. Spiridon\u201d Emergency Clinical County Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Corlade-Andrei","sequence":"additional","affiliation":[{"name":"S.C. Atto Digital USA S.R.L., 700045 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1721-2360","authenticated-orcid":false,"given":"Victorita","family":"Sorodoc","sequence":"additional","affiliation":[{"name":"2nd Internal Medicine Clinic, \u201cSt. Spiridon\u201d Emergency Clinical County Hospital, 700111 Iasi, Romania"},{"name":"Internal Medicine Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Cimpoesu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Emergency Department, \u201cSt. Spiridon\u201d Emergency Clinical County Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,26]]},"reference":[{"key":"ref_1","first-page":"188","article-title":"EuReCa ONE-27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe","volume":"105","author":"Lefering","year":"2016","journal-title":"Resuscitation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.resuscitation.2019.12.042","article-title":"Survival after out-of-hospital cardiac arrest in Europe\u2014Results of the EuReCa TWO study","volume":"148","author":"Wnent","year":"2020","journal-title":"Resuscitation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.hlc.2018.08.026","article-title":"Epidemiology of Sudden Cardiac Death: Global and Regional Perspectives","volume":"28","author":"Wong","year":"2019","journal-title":"Heart Lung Circ."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1056\/NEJM199711203372103","article-title":"Outcome of survivors of accidental hypothermia and circulatory arrest treated with extracorporeal blood warming","volume":"337","author":"Walpoth","year":"1997","journal-title":"N. 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