Guidelines for extracorporeal cardiopulmonary resuscitation in children and adults: New ELSO statements in ASAIO Journal


(February 1, 2021) — Extracorporeal cardiopulmonary resuscitation (ECPR) is a potentially lifesaving treatment for patients in cardiac arrest when the circulation can’t be restored by conventional CPR. New guidelines for ECPR in adults and children, developed by the Extracorporeal Life Support Organization (ELSO), are presented by the ASAIO Journal, official journal of the American Society for Artificial Internal Organs. The journal is published in the Lippincott portfolio by Wolters Kluwer.

A specialized application of extracorporeal membrane oxygenation (ECMO), ECPR is increasingly being used to provide a chance for survival in patients with a broadening range of conditions. “This ELSO guideline is intended to be a practical guide to implementing ECPR and the early management following establishment of ECMO support,” according to the interim guideline statement for ECPR in adults. Alexander (Sacha) C. Richardson, BMBCh, MA, MRCP, FCICM, of The Alfred Hospital, Melbourne, Australia, is lead author of the adult guideline. Anne-Marie Guerguerian, MD, PhD, of the Hospital for Sick Children, Toronto, is lead author of the pediatric ECPR guideline.


New ELSO guidelines set standards for ECPR support

In ECPR, the patient’s circulation and gas exchange are restored using ECMO in the context of cardiopulmonary resuscitation measures. ECPR is performed as an emergency measure in selected patients with potentially treatable causes of cardiac arrest, but who don’t achieve return of spontaneous circulation with conventional CPR.

“By providing organ perfusion, [ECPR] provides time for the delivery of interventions necessary to regain an adequate native circulation,” Dr. Richardson and colleagues write. “ECPR is a time-sensitive, complex intervention that requires teamwork, clearly defined roles, and well-trained health care providers.”

While the availability and use of ECPR have been increasing, evidence to guide practice in key areas is still limited. Topics addressed in the new ELSO guidelines include:

  • Selection of patients who may benefit from ECPR, as well as the timing and location of this advanced life support technology
  • Approaches to cannulation: placement of the lines through which the patient’s blood will be routed out of the body through a vein, oxygenated outside the body, and returned through an artery (V-A ECMO)
  • Connection and establishment of ECPR support, including steps for care management after cardiac arrest
  • Initial care while the patient is on ECMO, including imaging studies to monitor the patient’s condition and prepare for any necessary tests and treatment
  • Weaning off ECMO: steps for removing the patient from extracorporeal life support and restoring natural circulation, if possible

The guidelines also address the process of developing an ECPR program, including resources, staff training and competency, and quality assurance. Use of ECPR also raises unique issues related to ethics and patient consent, as well as special considerations in patients with out-of-hospital cardiac arrest.

Children undergoing ECPR differ from adults in several ways: because many children who need ECPR are already hospitalized for congenital heart disease surgery, ECPR access and restoration of circulation can often be achieved more rapidly. Children generally have better survival and short-term outcomes after ECPR. However, in children as in adults, there are limited data on long-term outcomes.

The two new ELSO statements were created by international, interdisciplinary teams. Recommendations are based on the best available research and on expert consensus where evidence is lacking, and will be updated as further evidence becomes available.





About ASAIO Journal

ASAIO Journal, the official publication of the American Society for Artificial Internal Organs, is in the forefront of artificial organ research and development. On the cutting edge of innovative technology, it features peer-reviewed articles of the highest quality that describe research, development, the most recent advances in the design of artificial organ devices and findings from initial testing. Published in eight issues annually, the ASAIO Journal features state-of-the-art investigations, laboratory and clinical trials, and discussions and opinions from experts around the world.


About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2019 annual revenues of €4.6 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students with advanced clinical decision support, learning and research and clinical intelligence. For more information about our solutions, visit and follow us on LinkedIn and Twitter @WKHealth.

For more information, visit, follow us on Twitter, Facebook, LinkedIn, and YouTube.



Wolters Kluwer Health, 01.02.2021 (tB).

Schlagwörter: , ,


Inadequate sequencing of SARS-CoV-2 variants impedes global response to COVID-19
New meta-analysis finds cannabis may be linked to development of…
New guidance on how to diagnosis and manage osteoporosis in…
Starting the day off with chocolate could have unexpected benefits
Better mental health supports for nurses needed, study finds


Versorgung verbessern: Deutsche Gesellschaft für Schmerzmedizin fordert die Einführung des…
Pflegeexpertise im Fokus: Schmerzmanagement nach Operationen
Versorgung verbessern: Bundesweite Initiative der Deutschen Gesellschaft für Schmerzmedizin zu…
Jedes vierte Kind wünscht bessere Schmerzbehandlung
Lebensqualität von Patienten in der dauerhaften Schmerztherapie mit Opioiden verbessern


„Wissen was bei Diabetes zählt: Gesünder unter 7 PLUS“ gibt…
Toujeo® bei Typ-1-Diabetes: Weniger schwere Hypoglykämien und weniger Ketoazidosen 
Bundestag berät über DMP Adipositas: DDG begrüßt dies als Teil…
Mit der Smartwatch Insulinbildung steuern
Verbände fordern bessere Ausbildung und Honorierung von Pflegekräften für Menschen…


Wie eine Diät die Darmflora beeinflusst: Krankenhauskeim spielt wichtige Rolle…
DGEM plädiert für Screening und frühzeitige Aufbautherapie: Stationäre COVID-19-Patienten oft…
Führt eine vegane Ernährungsweise zu einer geringeren Knochengesundheit?
Regelmässiger Koffeinkonsum verändert Hirnstrukturen
Corona-Erkrankung: Fehl- und Mangelernährung sind unterschätze Risikofaktoren


Anti-Myelom-Therapie mit zusätzlich Daratumumab noch effektiver
Positive Ergebnisse beim fortgeschrittenen Prostatakarzinom: Phase-III-Studie zur Radioligandentherapie mit 177Lu-PSMA-617
Lymphom-News vom EHA2021 Virtual. Alle Berichte sind nun online verfügbar!
Deutsch-dänisches Interreg-Projekt: Grenzübergreifende Fortbildungskurse in der onkologischen Pflege
Sotorasib: Neues Medikament macht Lungenkrebs-Patienten Hoffnung


NMOSD-Erkrankungen: Zulassung von Satralizumab zur Behandlung von Jugendlichen und Erwachsenen
Verzögerte Verfügbarkeit von Ofatumumab (Kesimpta®)
Neuer Biomarker bei Multipler Sklerose ermöglicht frühe Risikoeinschätzung und gezielte…
Multiple Sklerose beginnt oft lange vor der Diagnose
Goldstandard für Versorgung bei Multipler Sklerose


Meilenstein in der Parkinson-Frühdiagnose
Parkinson-Erkrankte besonders stark von Covid-19 betroffen
Gangstörungen durch Kleinhirnschädigung beim atypischen Parkinson-Syndrom
Parkinson-Agenda 2030: Die kommenden 10 Jahre sind für die therapeutische…
Gemeinsam gegen Parkinson: bessere Therapie durch multidisziplinäre Versorgung