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High-Quality Intensive Care Medicine

University Medicine: The innovative use of eCPR and ECMO greatly improves chances of survival.

Professor Jens Meier, Credit: Claudia Börner
Professor Jens Meier, Credit: Claudia Börner

Congestive heart failure or V-fib can cause an individual to lose consciousness and collapse. Providing someone close by can quickly administer first aid before paramedics arrive by starting CPR or mouth-to-mouth resuscitation, the individual stands a fairly good chance of recovering. The Kepler University Hospital is one of just a handful of centers in Austria to apply eCPR (extracorporeal resuscitation). Prof. Dr. Jens Meier, head of the Department of Anesthesiology and Operative Intensive Care Medicine, describes the premise to apply this particular method: "In order for eCPR to work, the important thing is fast on-site assistance and an expeditious route to the hospital so that we can begin oxygenating the individual’s brain cells."

Once at the hospital, a team of doctors in different fields will assess the patient’s situation and provide further care. If needed, doctors can start so-called ECMO therapy (Extracorporeal Membrane Oxygenation = oxygen absorption via an external membrane).

Two ECMO Therapies
In cases of acute heart failure, veno-arterial ECMO can be used to assist – or entirely assume - the heart and/or lung function for a period of time. The oxygen-poor blood is pumped out of the patient’s body to the oxygenator by means of the large cannula in the right inguinal vein. The oxygenated blood then bypasses the heart and returns directly to the main circulation by way of a large cannula in the left inguinal artery. This bypasses the pulmonary circulation, relieving the heart, and improving blood flow to the coronary arteries. The veno-venous ECMO procedure can only support the pulmonary system. Prof. Meier remarked: "During the COVID pandemic, we used this method about a hundred times a year." He added that ECMO can usually be applied for about three to four weeks without experiencing major problems and after that, however, the risk of complications increases. While comprehensive research findings are not yet available, experience has shown that ECMO patients have a significantly higher survival rate.

Base-Knowledge Research
The Johannes Kepler University Linz is currently in the final phase of an EU project involving partnerships with the teaching hospitals in Freiburg (Germany) and Rotterdam (the Netherlands). Prof. Meier stated: "We are highly regarded because of our research, which allows us to offer our patients innovative medical care."