Abstract：
Extracorporeal Cardiopulmonary Resuscitation (ECPR) has potential benefits compared to conventional Cardiopulmonary Resuscitation (CCPR) in children. Although no randomised trials for paediatric ECPR have been conducted, there is extensive literature on survival, neurological outcome and risk factors for survival. Based on current literature and guidelines, we suggest recommendations for deployment of paediatric ECPR emphasising the requirement for protocols, training, and timely intervention to enhance patient outcomes. Factors related to outcomes of paediatric ECPR include initial underlying rhythm, CCPR duration, quality of CCPR, medications during CCPR, cannulation site, acidosis and renal dysfunction. Based on current evidence and experience, we provide an approach to patient selection, ECMO initiation and management in ECPR regarding blood and sweep flow settings, unloading of the left ventricle, diagnostics whilst on ECMO, temperature targets, neuromonitoring as well as suggested weaning and decannulation strategies.
摘要：
体外心肺复苏（ECPR）与传统心肺复苏（CCPR）相比，在儿童中具有潜在的益处。尽管尚未进行儿科ECPR的随机试验，有大量关于生存的文献，神经系统预后和生存的危险因素。根据当前的文献和指南，我们建议部署儿科ECPR的建议，强调方案的要求，培训,并及时干预，以提高患者的治疗效果。与儿科ECPR结果相关的因素包括初始潜在节律，CCPR持续时间,CCPR的质量，CCPR期间的药物，插管部位,酸中毒和肾功能不全。根据目前的证据和经验,我们提供了一种选择患者的方法，ECPR中关于血液和扫描流量设置的ECMO启动和管理，左心室的卸载，在ECMO上进行诊断，温度目标,神经监测以及建议的断奶和拔管策略。
