Medical Intervention Car with Cardiohelp onboard
At the Heidelberg University Hospital (UKHD) in Germany, Dr. Niko Schneider and his colleagues have further developed their Medical Intervention Car (MIC), which has been on the road since 2019, providing extracorporeal cardiopulmonary support to patients in the field. Today, Getinge's Cardiohelp is always on board.
According to the German Resuscitation Registry, rescue services attempted resuscitation in around 60,000 patients in Germany in 2020, after an out-of-hospital cardiovascular arrest.1 Despite the immediate initiation of cardiopulmonary resuscitation (CPR), the survival rate with a favorable neurological outcome is low.2
Extracorporeal cardiopulmonary resuscitation (eCPR) can be considered as a rescue attempt for preselected patients with refractory cardiovascular arrest and potentially reversible etiology. The results of observational studies suggest that eCPR is associated with an increase in survival of up to 30% compared with conventional CPR in selected patients.3, 4
“Our MIC has been on the road since 2019, as an addition to our regular emergency vehicles. Since then, it has become clear to us that there are people who could benefit from more invasiveness on the road. That’s why we choose Getinge’s Cardiohelp to be able to do eCPR on site,” says Dr. Niko Schneider, emergency doctor at the Heidelberg University Hospital (UKHD).
Getinge's Cardiohelp makes eCPR possible in the field, and the goal of Dr. Schneider and his team is to treat patients with VA-ECMO to bridge the time until they are admitted to the hospital for other therapies.
The MIC offers the possibility of carrying out special advanced life-saving medical interventions at the scene of an emergency, which are currently only possible to a limited extent or not at all in a regular Emergency ambulance.
“With the MIC we want to complement emergency care on site and generate high level of patient safety. The sooner adequate perfusion and oxygenation can take place, the better the outcome. The complexity of the ECMO procedure requires a high level of professional expertise, but we have that in our team, along with enthusiasm. We can now achieve neurological outcomes that were previously unthinkable.”
A prospective, randomized trial is currently underway to demonstrate that patients benefit from the use of early eCPR.
“Without being able to prove it scientifically so far, we can say that some of the patients we cannulated in cardiac arrest, who we thought had no chance, we were able to discharge to other hospitals, or they walked out of our hospital on their own two feet.”
Dr. Schneider is a big supporter of the early use of ECMO in the rescue chain.
“We need a paradigm shift in the rescue chain which has not changed significantly during the last 30 years. We cannot generate the successes we achieve with Cardiohelp and ECMO with hands or resuscitation machines. Our next mission is to add Cardiohelp to our rescue helicopters, to offer more alternatives for patients also in very remote locations.”
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 Fischer M et al (2021) Jahresbericht des Deutschen Reanimationsregisters Außerklinische Reanimation 2020. Anästh Intensivmed, 2021. 62: p. V68–V73.
2 Karam N et al (2017) Characteristics and outcomes of out-of-hospital sudden cardiac arrest according to the time of occurrence. Resuscitation 116:16–21.
3 Michels G et al (2018) Recommendations for extracorporeal cardiopulmonary resuscitation (eCPR): Consensus statement of DGIIN, DGK, DGTHG, DGfK, DGNI, DGAI, DIVI and GRC. Anaesthesist 67(8):607-616.
4 Debaty G et al (2017) Prognostic factors for extracorporeal cardiopulmonary resuscitation recipients following out-of-hospital refractory cardiac arrest. A systematic review and meta-analysis. Resuscitation 112:1–10