Extracorporeal CPR brings new hope for cardiac arrest patients

ORLANDO, Fla. — Suffering sudden cardiac arrest outside of a health care facility is often fatal, and those who survive are frequently left with serious long-term neurological consequences. Now, AdventHealth and Orange County are teaming up to provide an innovative lifesaving treatment for cardiac arrest patients.

New evidence has found that extracorporeal membrane oxygenation (ECMO) CPR may substantially improve survivability and preserve brain tissue for patients after suffering cardiac arrest. ECMO is a procedure in which a machine is used to pump blood out of the body, remove carbon dioxide, infuse the blood with oxygen, and return it to the patient’s body. The blood bypasses the lungs, or both the heart and lungs, depending on the situation. The clinical team can work on the patient’s heart while the ECMO machine keeps the patient alive.

Orange County has designated AdventHealth Orlando as a comprehensive resuscitation center, meaning county EMS teams will bring qualifying patients to the facility while providing automated CPR while in transit. To qualify, a patient must be between 18-70 years old, with no terminal conditions, and be no more than 45 minutes away from AdventHealth Orlando.

“If someone has a cardiac arrest in most places in Orange County, and they meet criteria for this lifesaving procedure, we will work closely with our EMS partners and will be standing by at AdventHealth Orlando to give them a much better chance to be brought back to life,” said Dr. Eduardo Oliveira, executive medical director of critical care services for AdventHealth Central Florida.

The program offers new hope for patients across Orange County who may face life-threatening cardiac emergencies.

“ECMO CPR has the potential to decrease mortality in sudden cardiac arrest, while also improving neurological outcomes for many patients,” said Dr. Christian Zuver, medical director for the Orange County Emergency Medical Services System. “We’re still providing high-quality CPR, early appropriate defibrillation, and ventilating but we’re changing how personnel identify cardiac situations. If they meet the criteria for ECMO CPR, then the responding EMS agency knows to get the patient to the comprehensive resuscitation center immediately.”

The change incorporates cutting-edge science along with policies and procedures adopted from other high-functioning EMS systems around the world.

“We’ve provided extensive training to the pre-hospital providers in the system in an effort to ensure each agency in the Orange County EMS system understands the rationale for the change and knows what to look for when responding to a patient,” said Dr. Zuver.

AdventHealth has one of the largest ECMO programs in the country, with 32 adult beds, 10 pediatric beds, 28 adults ECMO specialists, and more than 250 specially trained team members including advanced practice providers, physicians, nurses, pharmacists, respiratory therapists and support staff. The program gained national prominence during the COVID-19 pandemic, treating patients while significantly exceeding the national average survival rate.

The program launched in late March, operating from 7 a.m.-7 p.m. Once additional staff are trained, the program will expand to 24/7 availability.