{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:03:02Z","timestamp":1779696182255,"version":"3.53.1"},"reference-count":169,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a promising strategy for refractory cardiac arrest, enabling the restoration of systemic perfusion when conventional resuscitation fails. However, uncertainties remain regarding patient selection, timing and implementation. Methods: A narrative review of experimental data, clinical studies, randomized trials and international recommendations was performed. Particular emphasis was placed on the interplay between physiological mechanisms, real-world organizational models and decision-making processes. Results: ECPR can restore effective circulation, preserve end organ perfusion and serve as a bridge to definitive etiologic treatment, with the potential to improve survival and neurological outcomes in highly selected patients. However, its effectiveness is strongly dependent on rapid deployment, structured systems of care and multidisciplinary coordination. Significant challenges remain, including in relation to the heterogeneity of protocols, high resource utilization, complications with extracorporeal support and the complexity of post-resuscitation management. Furthermore, ECPR fundamentally alters traditional resuscitation paradigms, introducing ethical dilemmas related to patient selection, prognostication and the allocation of limited resources. Conclusions: ECPR represents a transition from procedure-based resuscitation to system-based extracorporeal support. Its clinical benefit is contingent upon timely implementation within optimized organizational frameworks and integration with definitive treatment pathways. Future research should focus on refining selection criteria, standardizing care pathways and addressing ethical sustainability challenges to ensure appropriate and effective use of this evolving technology.<\/jats:p>","DOI":"10.3390\/life16050857","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:42:18Z","timestamp":1779691338000},"page":"857","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporeal Membrane Oxygenation in Refractory Cardiac Arrest: Current Evidence, Clinical Pathways and Future Directions"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5046-4275","authenticated-orcid":false,"given":"Debora Emanuela","family":"Torre","sequence":"first","affiliation":[{"name":"Department of Cardiac Anesthesia and Intensive Care Unit, Cardiac Surgery, Ospedale Dell\u2019Angelo, 30174 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Mangino","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Ospedale Dell\u2019Angelo, 30174 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0119-6549","authenticated-orcid":false,"given":"Carmelo","family":"Pirri","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10231","DOI":"10.1038\/s41598-023-35735-y","article-title":"Impact of community-based interventions on out-of-hospital cardiac arrest outcomes: A systematic review and meta-analysis","volume":"13","author":"Simmons","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/j.resuscitation.2011.01.032","article-title":"A pilot study of mechanical chest compressions with the LUCASTM device in cardiopulmonary resuscitation","volume":"82","author":"Smekal","year":"2011","journal-title":"Resuscitation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S2213-2600(25)00122-5","article-title":"Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest","volume":"13","author":"Supady","year":"2025","journal-title":"Lancet Respir. Med."},{"key":"ref_4","first-page":"540","article-title":"Extracorporeal cardiopulmonary resuscitation for refractory OHCA: Lessons from three randomized controlled trials-the trialists\u2019 view","volume":"12","author":"Ubben","year":"2023","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ijcard.2021.12.053","article-title":"Extracorporeal cardiopulmonary resuscitation for refractory in-hospital cardiac arrest: A retrospective cohort study","volume":"350","author":"Bourcier","year":"2022","journal-title":"Int. J. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.resuscitation.2008.09.017","article-title":"Post-cardiac arrest syndrome: Epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke","volume":"79","author":"Nolan","year":"2008","journal-title":"Resuscitation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.resuscitation.2016.12.009","article-title":"ECMO Cardio-Pulmonary Resuscitation (ECPR), trends in survival from an international multicentre cohort study over 12-years","volume":"112","author":"Richardson","year":"2017","journal-title":"Resuscitation"},{"key":"ref_8","unstructured":"Extracorporeal Life Support Organization (ELSO) ELSO Registry [Internet]. Available online: https:\/\/www.elso.org\/registry\/elsoliveregistrydashboard.aspx."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.resuscitation.2016.01.019","article-title":"Comparing extracorporeal cardiopulmonary resuscitation with conventional cardiopulmonary resuscitation: A meta-analysis","volume":"103","author":"Kim","year":"2016","journal-title":"Resuscitation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1186\/s13019-025-03708-z","article-title":"Extra-corporeal-cardiopulmonary-resuscitation vs. conventional-cardiopulmonary-resuscitation: An in-depth look into short- and long-term neurological outcomes","volume":"20","author":"Yasmin","year":"2025","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1016\/S0140-6736(20)32338-2","article-title":"Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): A phase 2, single centre, open-label, randomised controlled trial","volume":"396","author":"Yannopoulos","year":"2020","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1001\/jama.2022.1025","article-title":"Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial","volume":"327","author":"Belohlavek","year":"2022","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1056\/NEJMoa2204511","article-title":"Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest","volume":"388","author":"Suverein","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1164\/rccm.201409-1634OC","article-title":"Association of hospital-level volume of extracorporeal membrane oxygenation cases and mortality. Analysis of the extracorporeal life support organization registry","volume":"191","author":"Barbaro","year":"2015","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/j.surg.2023.02.004","article-title":"A contemporary analysis of the volume-outcome relationship for extracorporeal membrane oxygenation in the United States","volume":"173","author":"Verma","year":"2023","journal-title":"Surgery"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"8309","DOI":"10.1038\/s41598-024-58808-y","article-title":"Impact of center volume on in-hospital mortality in adult patients with out-of-hospital cardiac arrest resuscitated using extracorporeal cardiopulmonary resuscitation: A secondary analysis of the SAVE-J II study","volume":"14","author":"Misumi","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1007\/s00134-021-06548-2","article-title":"Brain injury after cardiac arrest: Pathophysiology, treatment, and prognosis","volume":"47","author":"Sandroni","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"ivac219","DOI":"10.1093\/icvts\/ivac219","article-title":"Systematic review and meta-analysis comparing low-flow duration of extracorporeal and conventional cardiopulmonary resuscitation","volume":"35","author":"Mandigers","year":"2022","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3109\/10903120903349796","article-title":"Coronary perfusion pressure and return of spontaneous circulation after prolonged cardiac arrest","volume":"14","author":"Reynolds","year":"2010","journal-title":"Prehosp. Emerg. Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.resuscitation.2020.05.038","article-title":"Relationship between hemodynamic parameters and cerebral blood flow during cardiopulmonary resuscitation","volume":"153","author":"Debaty","year":"2020","journal-title":"Resuscitation"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1016\/j.resuscitation.2014.08.032","article-title":"Systematic review of the mechanisms driving effective blood flow during adult CPR","volume":"85","author":"Georgiou","year":"2014","journal-title":"Resuscitation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/B978-0-12-394309-5.00006-7","article-title":"Cell biology of ischemia\/reperfusion injury","volume":"298","author":"Kalogeris","year":"2012","journal-title":"Int. Rev. Cell Mol. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1146\/annurev-pharmtox-010715-103335","article-title":"Mitochondrial Dysfunction and Myocardial Ischemia-Reperfusion: Implications for Novel Therapies","volume":"57","author":"Lesnefsky","year":"2017","journal-title":"Annu. Rev. Pharmacol. Toxicol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"C967","DOI":"10.1152\/ajpcell.1990.258.6.C967","article-title":"Effects of changes of pH on the contractile function of cardiac muscle","volume":"258","author":"Orchard","year":"1990","journal-title":"Am. J. Physiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1097\/CCM.0000000000006185","article-title":"Extracorporeal Cardiopulmonary Resuscitation","volume":"52","author":"Tonna","year":"2024","journal-title":"Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.21037\/jtd.2017.05.33","article-title":"What is extracorporeal cardiopulmonary resuscitation?","volume":"9","author":"Pappalardo","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s40635-019-0249-y","article-title":"Extracorporeal life support and systemic inflammation","volume":"7","author":"Pettenuzzo","year":"2019","journal-title":"Intensive Care Med. Exp."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Cassara, C.M., Long, M.T., Dollerschell, J.T., Chae, F., Hall, D.J., Demiralp, G., Stampfl, M.J., Bernardoni, B., McCarthy, D.P., and Glazer, J.M. (2022). Extracorporeal Cardiopulmonary Resuscitation: A Narrative Review and Establishment of a Sustainable Program. Medicina, 58.","DOI":"10.3390\/medicina58121815"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e004905","DOI":"10.1161\/CIRCHEARTFAILURE.118.004905","article-title":"Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and Cardiac Arrest","volume":"11","author":"Rao","year":"2018","journal-title":"Circ. Heart Fail."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2452","DOI":"10.1161\/CIRCULATIONAHA.108.190652","article-title":"Post-cardiac arrest syndrome: Epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa); the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; and the Stroke Council","volume":"118","author":"Neumar","year":"2008","journal-title":"Circulation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.1161\/CIRCULATIONAHA.113.002408","article-title":"Duration of resuscitation efforts and functional outcome after out-of-hospital cardiac arrest: When should we change to novel therapies?","volume":"128","author":"Reynolds","year":"2013","journal-title":"Circulation"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1159\/000092888","article-title":"Gene expression of the Na-Ca2+ exchanger, SERCA2a and calsequestrin after myocardial ischemia in the neonatal rabbit heart","volume":"90","author":"Seehase","year":"2006","journal-title":"Biol. Neonate"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1161\/hh2101.098547","article-title":"A novel mechanism for myocardial stunning involving impaired Ca2+ handling","volume":"89","author":"Kim","year":"2001","journal-title":"Circ. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1002\/ejhf.850","article-title":"Modalities and Effects of Left Ventricle Unloading on Extracorporeal Life support: A Review of the Current Literature","volume":"19","author":"Meani","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"39992","DOI":"10.31083\/RCM39992","article-title":"Harlequin Syndrome in Venoarterial ECMO and ECPELLA: When ECMO and Native or Impella Circulations Collide\u2014A Comprehensive Review","volume":"26","author":"Torre","year":"2025","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/CCM.0b013e3181feb339","article-title":"Extracorporeal cardiopulmonary resuscitation in patients with inhospital cardiac arrest: A comparison with conventional cardiopulmonary resuscitation","volume":"39","author":"Shin","year":"2011","journal-title":"Crit. Care Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1007\/s00134-016-4536-8","article-title":"Extracorporeal life support during cardiac arrest and cardiogenic shock: A systematic review and meta-analysis","volume":"42","author":"Ouweneel","year":"2016","journal-title":"Intensive Care Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"110069","DOI":"10.1016\/j.resuscitation.2023.110069","article-title":"Accredited cardiac arrest centers facilitate eCPR and improve neurological outcome","volume":"194","author":"Thevathasan","year":"2024","journal-title":"Resuscitation"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Olson, T., Anders, M., Burgman, C., Stephens, A., and Bastero, P. (2022). Extracorporeal cardiopulmonary resuscitation in adults and children: A review of literature, published guidelines and pediatric single-center program building experience. Front. Med., 9.","DOI":"10.3389\/fmed.2022.935424"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s13049-017-0440-7","article-title":"Neurological outcomes and duration from cardiac arrest to the initiation of extracorporeal membrane oxygenation in patients with out-of-hospital cardiac arrest: A retrospective study","volume":"25","author":"Yukawa","year":"2017","journal-title":"Scand. J. Trauma. Resusc. Emerg. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1253\/circj.CJ-18-1257","article-title":"Patients with Refractory Out-of-Cardiac Arrest and Sustained Ventricular Fibrillation as Candidates for Extracorporeal Cardiopulmonary Resuscitation\u2014Prospective Multi-Center Observational Study","volume":"83","author":"Nakashima","year":"2019","journal-title":"Circ. J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.resuscitation.2016.12.011","article-title":"Prognostic factors for extracorporeal cardiopulmonary resuscitation recipients following out-of-hospital refractory cardiac arrest. A systematic review and meta-analysis","volume":"112","author":"Debaty","year":"2017","journal-title":"Resuscitation"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3424","DOI":"10.1016\/j.ijcard.2013.04.183","article-title":"Two-year survival and neurological outcome of in-hospital cardiac arrest patients rescued by extracorporeal cardiopulmonary resuscitation","volume":"168","author":"Shin","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s13054-017-1744-8","article-title":"Influence of low-flow time on survival after extracorporeal cardiopulmonary resuscitation (eCPR)","volume":"21","author":"Wengenmayer","year":"2017","journal-title":"Crit. Care"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jcrc.2018.08.006","article-title":"Low-flow time is associated with a favorable neurological outcome in out-of-hospital cardiac arrest patients resuscitated with extracorporeal cardiopulmonary resuscitation","volume":"48","author":"Otani","year":"2018","journal-title":"J. Crit. Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ajem.2023.10.024","article-title":"Low-flow time and outcomes in out-of-hospital cardiac arrest patients treated with extracorporeal cardiopulmonary resuscitation","volume":"75","author":"Shoji","year":"2024","journal-title":"Am. J. Emerg. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/S0140-6736(08)60958-7","article-title":"Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: An observational study and propensity analysis","volume":"372","author":"Chen","year":"2008","journal-title":"Lancet"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.annemergmed.2016.10.001","article-title":"Development and Implementation of a Comprehensive, Multidisciplinary Emergency Department Extracorporeal Membrane Oxygenation Program","volume":"70","author":"Tonna","year":"2017","journal-title":"Ann. Emerg. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.ajem.2024.01.013","article-title":"Optimal chest compression for cardiac arrest until the establishment of ECPR: Secondary analysis of the SAVE-J II study","volume":"78","author":"Nagashima","year":"2024","journal-title":"Am. J. Emerg. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13613-023-01174-1","article-title":"Percutaneous cannulation is associated with lower rate of severe neurological complication in femoro-femoral ECPR: Results from the Extracorporeal Life Support Organization Registry","volume":"13","author":"Wang","year":"2023","journal-title":"Ann. Intensive Care"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Burns, B., Kruit, N., Dennis, M., Shinar, Z., Rees, P., Wong, S., Plunkett, B., Reid, C., Carley, S., and Yannopoulos, D. (2025). Common femoral artery access in emergency medicine. Emerg. Med. J., 1\u20135.","DOI":"10.1136\/emermed-2025-215295"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"E263","DOI":"10.1111\/aor.12942","article-title":"Efficacy of Distal Perfusion Cannulae in Preventing Limb Ischemia During Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis","volume":"41","author":"Juo","year":"2017","journal-title":"Artif. Organs"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.ccc.2017.06.002","article-title":"Cardiac Support: Emphasis on Venoarterial ECMO","volume":"33","author":"King","year":"2017","journal-title":"Crit. Care Clin."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"110149","DOI":"10.1016\/j.resuscitation.2024.110149","article-title":"Lactate and lactate clearance as predictors of one-year survival in extracorporeal cardiopulmonary resuscitation\u2014An international, multicentre cohort study","volume":"198","author":"Thevathasan","year":"2024","journal-title":"Resuscitation"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"109927","DOI":"10.1016\/j.resuscitation.2023.109927","article-title":"Time-saving effect of real-time ultrasound-guided cannulation for extracorporeal cardiopulmonary resuscitation: A multicenter retrospective cohort study","volume":"191","author":"Nakatsutsumi","year":"2023","journal-title":"Resuscitation"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1515\/bmt-2017-0107","article-title":"The peripheral cannulas in extracorporeal life support","volume":"64","author":"Strunina","year":"2019","journal-title":"Biomed. Eng."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1097\/MAT.0000000000000858","article-title":"Impact of Cannula Size on Clinical Outcomes in Peripheral Venoarterial Extracorporeal Membrane Oxygenation","volume":"65","author":"Kim","year":"2019","journal-title":"ASAIO J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1253\/circj.CJ-24-0442","article-title":"Association Between Cannula Size of Extracorporeal Membrane Oxygenation and Prognosis in Patients with Out-of-Hospital Cardiac Arrest\u2014A Secondary Analysis of the SAVE-J II Study","volume":"89","author":"Arai","year":"2025","journal-title":"Circ. J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.resuscitation.2017.04.014","article-title":"A Pre-Hospital Extracorporeal Cardio Pulmonary Resuscitation (ECPR) strategy for treatment of refractory out hospital cardiac arrest: An observational study and propensity analysis","volume":"117","author":"Lamhaut","year":"2017","journal-title":"Resuscitation"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Bertini, P., Sangalli, F., Meani, P., Marabotti, A., Rubino, A., Scolletta, S., Ajello, V., Aloisio, T., Baiocchi, M., and Monaco, F. (2024). Establishing an Extracorporeal Cardiopulmonary Resuscitation Program. Medicina, 60.","DOI":"10.3390\/medicina60121979"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/MAT.0000000000001344","article-title":"Extracorporeal Cardiopulmonary Resuscitation in Adults. Interim Guideline Consensus Statement From the Extracorporeal Life Support Organization","volume":"67","author":"Richardson","year":"2021","journal-title":"ASAIO J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.resuscitation.2021.02.011","article-title":"European Resuscitation Council Guidelines 2021, Cardiac arrest in special circumstances","volume":"161","author":"Lott","year":"2021","journal-title":"Resuscitation"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Torre, D.E., and Pirri, C. (2025). Point-of-Care Transesophageal Echocardiography in Emergency and Intensive Care: An Evolving Imaging Modality. Biomedicines, 13.","DOI":"10.3390\/biomedicines13112680"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Torre, D.E., and Pirri, C. (2025). Beyond Standard Parameters: Precision Hemodynamic Monitoring in Patients on Veno-Arterial ECMO. J. Pers. Med., 15.","DOI":"10.3390\/jpm15110541"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e3960","DOI":"10.1097\/MD.0000000000003960","article-title":"Role of blood gas analysis during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients","volume":"95","author":"Kim","year":"2016","journal-title":"Medicine"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.ajem.2022.11.013","article-title":"Extracorporeal cardiopulmonary resuscitation location, coronary angiography and survival in out-of-hospital cardiac arrest","volume":"64","author":"Kim","year":"2023","journal-title":"Am. J. Emerg. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"110717","DOI":"10.1016\/j.resuscitation.2025.110717","article-title":"Coronary angiography findings in patients with refractory out-of-hospital cardiac arrest treated with extracorporeal cardiopulmonary resuscitation: Prediction of lesion culprit of acute myocardial infarction","volume":"215","author":"Righetti","year":"2025","journal-title":"Resuscitation"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.ccc.2020.02.004","article-title":"Thrombolysis in Pulmonary Embolism: An Evidence-Based Approach to Treating Life-Threatening Pulmonary Emboli","volume":"36","author":"Kaplovitch","year":"2020","journal-title":"Crit. Care Clin."},{"key":"ref_69","first-page":"507","article-title":"Pulmonary embolism-related refractory out-of-hospital cardiac arrest and extracorporeal cardiopulmonary resuscitation: Prague OHCA study post hoc analysis","volume":"12","author":"Pudil","year":"2023","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Harbaum, L., Mihali, K., Ausb\u00fcttel, F., Schieffer, B., and Kreutz, J. (2025). Case Report of Successful Extracorporeal CPR (eCPR) in Refractory Cardiac Arrest Caused by Fulminant Pulmonary Embolism with Remarkable Recovery. Reports, 8.","DOI":"10.3390\/reports8030100"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s44158-025-00329-9","article-title":"Transesophageal echocardiography in cardiac arrest: Why, how, when, and where in clinical practice","volume":"6","author":"Vetrugno","year":"2026","journal-title":"J. Anesth. Analg. Crit. Care"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.21037\/jtd-23-43","article-title":"Early computed tomography after extracorporeal cardiopulmonary resuscitation on in-hospital survival: A retrospective cohort study","volume":"15","author":"Tong","year":"2023","journal-title":"J. Thorac. Dis."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.resuscitation.2019.11.024","article-title":"Early full-body computed tomography in patients after extracorporeal cardiopulmonary resuscitation (eCPR)","volume":"146","author":"Zotzmann","year":"2020","journal-title":"Resuscitation"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.resuscitation.2020.08.001","article-title":"Extracorporeal cardiopulmonary resuscitation for acute aortic dissection during cardiac arrest: A nationwide retrospective observational study","volume":"156","author":"Ohbe","year":"2020","journal-title":"Resuscitation"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Torre, D.E., and Pirri, C. (2025). Alternative Arterial Access in Veno-Arterial ECMO: The Role of the Axillary Artery. J. Clin. Med., 14.","DOI":"10.3390\/jcm14155413"},{"key":"ref_76","unstructured":"Cavozza, C., Campanella, A., Pellegrino, P., Regesta, T., Gherli, R., and Audo, A. (2020). Right subclavian artery cannulation for aortic dissection surgery, without infraclavicular incision. Multimed. Man. Cardiothorac. Surg."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.jchf.2020.12.012","article-title":"ECMO as a Bridge to Left Ventricular Assist Device or Heart Transplantation","volume":"9","author":"DeFilippis","year":"2021","journal-title":"JACC Heart Fail."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1051\/ject\/201749312","article-title":"Extracorporeal Life Support as a Rescue Measure for Managing Life-Threatening Arrythmia and Brugada Syndrome","volume":"49","author":"Beshish","year":"2017","journal-title":"J. Extra Corpor. Technol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1321.e1-3","DOI":"10.1016\/j.ajem.2015.11.061","article-title":"Extracorporeal CPR and therapeutic hypothermia for out-of-hospital cardiac arrest in a patient with congenital long QT syndrome","volume":"34","author":"Lee","year":"2016","journal-title":"Am. J. Emerg. Med."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Torre, D.E., Mangino, D., and Pirri, C. (2025). Veno-Arterial Extracorporeal Membrane Oxygenation in Cardiotoxic Drug-Induced Cardiogenic Shock: A Systematic Narrative Review. Life, 15.","DOI":"10.3390\/life15060925"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1080\/15563650.2019.1676896","article-title":"Clinical utility of venoarterial-extracorporeal membrane oxygenation (VA-ECMO) in patients with drug-induced cardiogenic shock: A retrospective study of the Extracorporeal Life Support Organizations\u2019 ECMO case registry","volume":"58","author":"Weiner","year":"2020","journal-title":"Clin. Toxicol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"344","DOI":"10.4103\/aca.aca_4_24","article-title":"Ibrutinib-Induced Ventricular Electrical Storm Successfully Managed with Veno-Arterial ECMO and Intralipid Administration: A Rare Case Report","volume":"27","author":"Torre","year":"2024","journal-title":"Ann. Card. Anaesth."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/j.healun.2023.02.1498","article-title":"Extracorporeal membrane oxygenation as a bridge to advanced heart failure therapies","volume":"42","author":"Acharya","year":"2023","journal-title":"J. Heart Lung Transplant."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1177\/02676591211005697","article-title":"Incremental effect of complications on mortality and hospital costs in adult ECMO patients","volume":"37","author":"Dhamija","year":"2022","journal-title":"Perfusion"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/MAT.0000000000000660","article-title":"The Starling Relationship and Veno-Arterial ECMO: Ventricular Distension Explained","volume":"64","author":"Dickstein","year":"2018","journal-title":"ASAIO J."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1161\/CIRCULATIONAHA.122.062371","article-title":"Unloading the Left Ventricle in Venoarterial ECMO: In Whom, When, and How?","volume":"147","author":"Ezad","year":"2023","journal-title":"Circulation"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.xjon.2021.10.042","article-title":"Extracorporeal membrane oxygenation evolution: Left ventricular unloading strategies","volume":"8","author":"Bernhardt","year":"2021","journal-title":"JTCVS Open"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.amjcard.2023.09.023","article-title":"Left Ventricular Unloading with Impella Versus IABP in Patients with VA-ECMO: A Systematic Review and Meta-Analysis","volume":"208","author":"Gandhi","year":"2023","journal-title":"Am. J. Cardiol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1007\/s00134-024-07645-8","article-title":"Position paper on the physiology and nomenclature of dual circulation during venoarterial ECMO in adults","volume":"50","author":"Badulak","year":"2024","journal-title":"Intensive Care Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1177\/02676591241233847","article-title":"How to mange differential hypoxemia during veno-arterial extracorporeal membrane oxygenation","volume":"39","author":"Hou","year":"2024","journal-title":"Perfusion"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/2049-6958-9-55","article-title":"Application of veno-arterial-venous extracorporeal membrane oxygenation in differential hypoxia","volume":"9","author":"Choi","year":"2014","journal-title":"Multidiscip. Respir. Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1177\/0267659119830513","article-title":"Differential hypoxemia during venoarterial extracorporeal membrane oxygenation","volume":"34","author":"Falk","year":"2019","journal-title":"Perfusion"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Hu, S., Lu, A., Pan, C., Zhang, B., Wa, Y.L., Qu, W., and Bai, M. (2022). Limb Ischemia Complications of Veno-Arterial Extracorporeal Membrane Oxygenation. Front. Med., 9.","DOI":"10.3389\/fmed.2022.938634"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.avsg.2024.11.002","article-title":"Acute Limb Ischemia in Patients on Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Support: A Ten-Year Single-Center Experience","volume":"111","author":"Nejim","year":"2025","journal-title":"Ann. Vasc. Surg."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"2608","DOI":"10.1016\/j.jtha.2024.06.007","article-title":"Acquired von Willebrand syndrome during extracorporeal membrane oxygenation support: A comprehensive review of current evidence: Communication from the ISTH SSC on perioperative and critical care thrombosis and hemostasis","volume":"22","author":"Frere","year":"2024","journal-title":"J. Thromb. Haemost."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"104039","DOI":"10.1016\/j.iccn.2025.104039","article-title":"The effectiveness of NIRS technology to the early diagnosis of lower limb ischemia in patients on peripheral VA ECMO: A systematic review and meta-analysis","volume":"89","author":"Coelho","year":"2025","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_97","first-page":"36","article-title":"Early vascular complications after percutaneous cannulation for extracorporeal membrane oxygenation for cardiac assist","volume":"82","author":"Avalli","year":"2016","journal-title":"Minerva Anestesiol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.emc.2022.09.012","article-title":"Extracorporeal Life Support for Trauma","volume":"41","author":"Hamera","year":"2023","journal-title":"Emerg. Med. Clin. North Am."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.4187\/respcare.10929","article-title":"Extracorporeal Membrane Oxygenation","volume":"68","author":"Wheeler","year":"2023","journal-title":"Respir. Care"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1097\/MAT.0000000000001230","article-title":"Thrombosis and Bleeding in Extracorporeal Membrane Oxygenation (ECMO) Without Anticoagulation: A Systematic Review","volume":"67","author":"Olson","year":"2021","journal-title":"ASAIO J."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1177\/0267659120932705","article-title":"Intracranial hemorrhage on extracorporeal membrane oxygenation: An international survey","volume":"36","author":"Cavayas","year":"2021","journal-title":"Perfusion"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1177\/02676591241250288","article-title":"Anticoagulation during extracorporeal membrane oxygenation: A narrative review","volume":"40","author":"Priest","year":"2025","journal-title":"Perfusion"},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Navaei, A., Kostousov, V., and Teruya, J. (2023). Is it time to switch to bivalirudin for ECMO anticoagulation?. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1237601"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s12028-023-01688-3","article-title":"Guidelines for Neuroprognostication in Comatose Adult Survivors of Cardiac Arrest","volume":"38","author":"Rajajee","year":"2023","journal-title":"Neurocrit. Care"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s13054-017-1670-9","article-title":"Clinical pathophysiology of hypoxic ischemic brain injury after cardiac arrest: A \u201ctwo-hit\u201d model","volume":"21","author":"Sekhon","year":"2017","journal-title":"Crit. Care"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"S673","DOI":"10.1161\/CIR.0000000000001375","article-title":"Part 11: Post-Cardiac Arrest Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"152","author":"Hirsch","year":"2025","journal-title":"Circulation"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1056\/NEJMoa2208686","article-title":"Oxygen Targets in Comatose Survivors of Cardiac Arrest","volume":"387","author":"Schmidt","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.resuscitation.2018.11.015","article-title":"Partial pressure of arterial carbon dioxide after resuscitation from cardiac arrest and neurological outcome: A prospective multi-center protocol-directed cohort study","volume":"135","author":"Hunter","year":"2019","journal-title":"Resuscitation"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.resuscitation.2021.02.012","article-title":"European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care","volume":"161","author":"Nolan","year":"2021","journal-title":"Resuscitation"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"2283","DOI":"10.1056\/NEJMoa2100591","article-title":"Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest","volume":"384","author":"Dankiewicz","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s40560-022-00622-7","article-title":"Extracorporeal cardiopulmonary resuscitation with temperature management could improve the neurological outcomes of out-of-hospital cardiac arrest: A retrospective analysis of a nationwide multicenter observational study in Japan","volume":"10","author":"Sakurai","year":"2022","journal-title":"J. Intensive Care"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"109886","DOI":"10.1016\/j.resuscitation.2023.109886","article-title":"Blood pressure targets and management during post-cardiac arrest care","volume":"189","author":"Skrifvars","year":"2023","journal-title":"Resuscitation"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1007\/s00134-014-3470-x","article-title":"Prognostication in comatose survivors of cardiac arrest: An advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine","volume":"40","author":"Sandroni","year":"2014","journal-title":"Intensive Care Med."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"704","DOI":"10.23736\/S0375-9393.21.14793-5","article-title":"A matter of timing: EEG monitoring for neurological prognostication after cardiac arrest in the era of targeted temperature management","volume":"87","author":"Khazanova","year":"2021","journal-title":"Minerva Anestesiol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s12028-010-9412-8","article-title":"Sedation confounds outcome prediction in cardiac arrest survivors treated with hypothermia","volume":"15","author":"Samaniego","year":"2011","journal-title":"Neurocrit. Care"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/s11940-019-0602-1","article-title":"The Influence of Therapeutics on Prognostication After Cardiac Arrest","volume":"21","author":"Agarwal","year":"2019","journal-title":"Curr. Treat. Options Neurol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1353\/nib.2020.0046","article-title":"How Should Physicians Manage Neuroprognosis with ECPR?","volume":"10","author":"McCurry","year":"2020","journal-title":"Narrat. Inq. Bioeth."},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Haertel, F., Babst, J., Bruening, C., Bogoviku, J., Otto, S., Fritzenwanger, M., Gecks, T., Ebelt, H., Moebius-Winkler, S., and Schulze, P.C. (2023). Effect of Hemolysis Regarding the Characterization and Prognostic Relevance of Neuron Specific Enolase (NSE) after Cardiopulmonary Resuscitation with Extracorporeal Circulation (eCPR). J. Clin. Med., 12.","DOI":"10.3390\/jcm12083015"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.ajem.2023.03.047","article-title":"Are serial neuron-specific enolase levels associated with neurologic outcome of ECPR patients: A retrospective multicenter observational study","volume":"69","author":"Kim","year":"2023","journal-title":"Am. J. Emerg. Med."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Szpinda, \u0141., Lis, M., Pruc, M., Goraj, W., Niewiadomska, I., Maslyk, M., Kotfis, K., Tan, H.L., Baldi, E., and Szarpak, L. (2025). Prognostic Value of Serum S100B Protein for Neurological Outcomes After Cardiac Arrest: A Systematic Review and Meta-Analysis. J. Clin. Med., 15.","DOI":"10.3390\/jcm15010238"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"e047548","DOI":"10.1161\/JAHA.125.047548","article-title":"Recommendations in Extracorporeal Cardiopulmonary Resuscitation Post Resuscitation Care Via An International, Modified Delphi Approach","volume":"15","author":"Dennis","year":"2026","journal-title":"J. Am. Heart Assoc."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s13054-017-1604-6","article-title":"The association of findings on brain computed tomography with neurologic outcomes following extracorporeal cardiopulmonary resuscitation","volume":"21","author":"Ryu","year":"2017","journal-title":"Crit. Care"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1007\/s00134-020-06198-w","article-title":"Prediction of poor neurological outcome in comatose survivors of cardiac arrest: A systematic review","volume":"46","author":"Sandroni","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1186\/s13054-024-05082-z","article-title":"Neurological monitoring and management for adult extracorporeal membrane oxygenation patients: Extracorporeal Life Support Organization consensus guidelines","volume":"28","author":"Cho","year":"2024","journal-title":"Crit. Care"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/MAT.0000000000001448","article-title":"Neurologic Outcomes After Extracorporeal Cardiopulmonary Resuscitation: Recent Experience at a Single High-Volume Center","volume":"68","author":"Podell","year":"2022","journal-title":"ASAIO J."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1016\/j.resuscitation.2014.01.031","article-title":"Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: A prospective observational study","volume":"85","author":"Sakamoto","year":"2014","journal-title":"Resuscitation"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1161\/01.CIR.0000023891.80661.AD","article-title":"Successful cardiopulmonary resuscitation after cardiac arrest as a \u201csepsis-like\u201d syndrome","volume":"106","author":"Adrie","year":"2002","journal-title":"Circulation"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1177\/02676591211049767","article-title":"Predictors of acute kidney injury in patients after extracorporeal cardiopulmonary resuscitation","volume":"38","author":"Gaisendrees","year":"2023","journal-title":"Perfusion"},{"key":"ref_129","doi-asserted-by":"crossref","unstructured":"Lee, Y.I., Kang, M.G., Ko, R.E., Park, T.K., Chung, C.R., Cho, Y.H., Jeon, K., Suh, G.Y., and Yang, J.H. (2020). The Impact of Hypoxic Hepatitis on Clinical Outcomes after Extracorporeal Cardiopulmonary Resuscitation. J. Clin. Med., 9.","DOI":"10.3390\/jcm9092994"},{"key":"ref_130","doi-asserted-by":"crossref","unstructured":"Pequignot, B., Lescroart, M., Orlowski, S., Reynette, N., Martini, B., Albuisson, E., Pina, H., Tran, N., Grandmougin, D., and Levy, B. (2022). Methylene Blue Reduces Fluid Loading and Norepinephrine Requirements for Post-Resuscitation Syndrome in a Pig Model of Refractory Cardiac Arrest Resuscitated with Veno-Arterial ECMO. J. Clin. Med., 11.","DOI":"10.3390\/jcm11092515"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/CCM.0000000000006946","article-title":"Acute Kidney Injury After Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest","volume":"54","author":"Taira","year":"2026","journal-title":"Crit. Care Med."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1186\/s13054-021-03676-5","article-title":"Acute kidney injury in ECMO patients","volume":"25","author":"Ostermann","year":"2021","journal-title":"Crit. Care"},{"key":"ref_133","doi-asserted-by":"crossref","unstructured":"Chen, S.W., Lu, Y.A., Lee, C.C., Chou, A.H., Wu, V.C., Chang, S.W., Fan, P.C., Tian, Y.C., Tsai, F.C., and Chang, C.H. (2019). Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0212352"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s12055-019-00920-0","article-title":"Renal replacement therapy during extracorporeal membrane oxygenation","volume":"37","author":"Subbarayan","year":"2021","journal-title":"Indian J. Thorac. Cardiovasc. Surg."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s13613-024-01281-7","article-title":"Influence of fluid accumulation on major adverse kidney events in critically ill patients\u2014An observational cohort study","volume":"14","author":"Hofer","year":"2024","journal-title":"Ann. Intensive Care"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1186\/s13613-020-00788-z","article-title":"Post-resuscitation shock: Recent advances in pathophysiology and treatment","volume":"10","author":"Jozwiak","year":"2020","journal-title":"Ann. Intensive Care"},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1159\/000500015","article-title":"Rationale of Hemoadsorption during Extracorporeal Membrane Oxygenation Support","volume":"48","author":"Napp","year":"2019","journal-title":"Blood Purif."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1053\/j.jvca.2024.02.028","article-title":"Diagnosis and Management of Vasoplegia in Temporary Mechanical Circulatory Support: A Narrative Review","volume":"38","author":"Ortoleva","year":"2024","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.resuscitation.2016.03.021","article-title":"Hypoxic hepatitis after out-of-hospital cardiac arrest: Incidence, determinants and prognosis","volume":"103","author":"Champigneulle","year":"2016","journal-title":"Resuscitation"},{"key":"ref_140","doi-asserted-by":"crossref","unstructured":"Appelt, H., Philipp, A., Mueller, T., Foltan, M., Lubnow, M., Lunz, D., Zeman, F., and Lehle, K. (2020). Factors associated with hemolysis during extracorporeal membrane oxygenation (ECMO)-Comparison of VA- versus VV ECMO. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227793"},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.34067\/KID.0000000000000253","article-title":"Intravascular Hemolysis and AKI in Children Undergoing Extracorporeal Membrane Oxygenation","volume":"4","author":"Strong","year":"2023","journal-title":"Kidney360"},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1055\/s-0043-1772843","article-title":"Detecting Oxygenator Thrombosis in ECMO: A Review of Current Techniques and an Exploration of Future Directions","volume":"50","author":"Leerson","year":"2024","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s13054-024-04946-8","article-title":"Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: A systematic review and meta-analysis","volume":"28","author":"Ibrahim","year":"2024","journal-title":"Crit. Care"},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"e39","DOI":"10.1097\/MAT.0000000000001494","article-title":"Management of Circuit Air in Extracorporeal Membrane Oxygenation: A Single Center Experience","volume":"68","author":"Chan","year":"2022","journal-title":"ASAIO J."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1053\/j.jvca.2009.08.002","article-title":"Extracorporeal membrane oxygenation for treating severe cardiac and respiratory failure in adults: Part 2-technical considerations","volume":"24","author":"Sidebotham","year":"2010","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/0267659120982572","article-title":"Switching to centrifugal pumps may decrease hemolysis rates among pediatric ECMO patients","volume":"37","author":"Johnson","year":"2022","journal-title":"Perfusion"},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1097\/00002480-200209000-00007","article-title":"Early experience with a polymethyl pentene oxygenator for adult extracorporeal life support","volume":"48","author":"Peek","year":"2002","journal-title":"ASAIO J."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1177\/0267659114531611","article-title":"Inter-hospital transfer of ECMO-assisted patients with a portable miniaturized ECMO device: 4 years of experience","volume":"30","author":"Metz","year":"2015","journal-title":"Perfusion"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"110403","DOI":"10.1016\/j.resuscitation.2024.110403","article-title":"Variability in patient selection criteria across extracorporeal cardiopulmonary resuscitation (ECPR) systems: A systematic review","volume":"204","author":"Alenazi","year":"2024","journal-title":"Resuscitation"},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"e016521","DOI":"10.1161\/JAHA.120.016521","article-title":"In-Depth Extracorporeal Cardiopulmonary Resuscitation in Adult Out-of-Hospital Cardiac Arrest","volume":"9","author":"Dennis","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"110769","DOI":"10.1016\/j.resuscitation.2025.110769","article-title":"European Resuscitation Council Guidelines 2025 Adult Advanced Life Support","volume":"215","author":"Soar","year":"2025","journal-title":"Resuscitation"},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"100234","DOI":"10.1016\/j.resplu.2022.100234","article-title":"The effect of a structured ECPR protocol aided by specific simulation training in a quaternary ECMO centre: A retrospective pre-post study","volume":"10","author":"Read","year":"2022","journal-title":"Resusc. Plus"},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/s13049-025-01448-6","article-title":"Immediate post-ECPR management strategies in the prehospital and critical care transport medicine environments","volume":"33","author":"Purington","year":"2025","journal-title":"Scand. J. Trauma. Resusc. Emerg. Med."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1097\/PCC.0000000000000234","article-title":"Implementation of an extracorporeal cardiopulmonary resuscitation simulation program reduces extracorporeal cardiopulmonary resuscitation times in real patients","volume":"15","author":"Su","year":"2014","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.acap.2019.01.005","article-title":"Impacts of a Pediatric Extracorporeal Cardiopulmonary Resuscitation (ECPR) Simulation Training Program","volume":"19","author":"Sawyer","year":"2019","journal-title":"Acad. Pediatr."},{"key":"ref_156","first-page":"484","article-title":"Cost-effectiveness of extracorporeal cardiopulmonary resuscitation vs. conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A pre-planned, trial-based economic evaluation","volume":"13","author":"Delnoij","year":"2024","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.resuscitation.2019.03.021","article-title":"Cost effectiveness and quality of life analysis of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest","volume":"139","author":"Dennis","year":"2019","journal-title":"Resuscitation"},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1007\/s41669-021-00272-9","article-title":"Hospital Costs of Extracorporeal Membrane Oxygenation in Adults: A Systematic Review","volume":"5","author":"Vermeulen","year":"2021","journal-title":"Pharmacoecon. Open"},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1186\/s13054-023-04534-2","article-title":"Prevalence, reasons, and timing of decisions to withhold\/withdraw life-sustaining therapy for out-of-hospital cardiac arrest patients with extracorporeal cardiopulmonary resuscitation","volume":"27","author":"Naito","year":"2023","journal-title":"Crit. Care"},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1053\/j.jvca.2020.01.037","article-title":"ECPR or Do Not ECPR-Who and How to Choose","volume":"34","author":"Kratzert","year":"2020","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.resuscitation.2016.01.016","article-title":"Association of early withdrawal of life-sustaining therapy for perceived neurological prognosis with mortality after cardiac arrest","volume":"102","author":"Elmer","year":"2016","journal-title":"Resuscitation"},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.mayocp.2018.09.020","article-title":"Decisions to Withdraw Extracorporeal Membrane Oxygenation Support: Patient Characteristics and Ethical Considerations","volume":"94","author":"DeMartino","year":"2019","journal-title":"Mayo Clin. Proc."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s12055-020-00922-3","article-title":"Ethical challenges of adult ECMO","volume":"37","author":"Ramanathan","year":"2021","journal-title":"Indian J. Thorac. Cardiovasc. Surg."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1086\/JCE2022331013","article-title":"Ethics of Extracorporeal Membrane Oxygenation under Conventional and Crisis Standards of Care","volume":"33","author":"Piscitello","year":"2022","journal-title":"J. Clin. Ethics"},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.resuscitation.2015.03.021","article-title":"Ethics in the use of extracorporeal cardiopulmonary resuscitation in adults","volume":"91","author":"Riggs","year":"2015","journal-title":"Resuscitation"},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"e465","DOI":"10.1097\/CCM.0000000000006549","article-title":"Society of Critical Care Medicine Guidelines on Family-Centered Care for Adult ICUs: 2024","volume":"53","author":"Hwang","year":"2025","journal-title":"Crit. Care Med."},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1007\/s00063-021-00796-2","article-title":"Extrakorporale kardiopulmonale Reanimation (eCPR) [Extracorporeal cardiopulmonary resuscitation (eCPR)]","volume":"117","author":"Pilarczyk","year":"2022","journal-title":"Med. Klin. Intensivmed. Notfmed."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1161\/CIRCULATIONAHA.120.048792","article-title":"Left Ventricular Unloading Is Associated with Lower Mortality in Patients with Cardiogenic Shock Treated with Venoarterial Extracorporeal Membrane Oxygenation: Results From an International, Multicenter Cohort Study","volume":"142","author":"Schrage","year":"2020","journal-title":"Circulation"},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s00134-021-06593-x","article-title":"Bleeding and thrombotic events in adults supported with venovenous extracorporeal membrane oxygenation: An ELSO registry analysis","volume":"48","author":"Nunez","year":"2022","journal-title":"Intensive Care Med."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/5\/857\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T07:11:46Z","timestamp":1779693106000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/5\/857"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":169,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["life16050857"],"URL":"https:\/\/doi.org\/10.3390\/life16050857","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]}}}