ECPR (Extra Corporeal Cardio Pulmonary Resuscitation): Challenges and Future in India

Abstract

Extra Corporeal Cardiopulmonary Resuscitation  is an growing modality  in refractory cardiac arrest by which  adequate circulation and oxygen delivery is restored and helps to improve the overall outcomes overcoming the limitations of conventional CPR. Evidence from international studies points to  improved survival and neurological outcomes in selected patients specifically  in in-hospital cardiac arrests,; But its benefit in out-of-hospital settings remains variable and highly dependent on many other factors and not without limitations. ECPR is a time-sensitive, resource-intensive intervention requiring a well-coordinated multidisciplinary team and robust infrastructure.In India, the adoption of ECPR is still in its developing stage  with limited data, absence of regional guidelines, and significant challenges and barriers. Despite these limitations, increasing ECMO experience, especially post-pandemic, gives us  an opportunity to expand ECPR programs in tertiary centers. Establishing national registries and improving public health measures such as CPR training may ultimately determine the broader impact of ECPR in India.