The Heart Team approach to cardiac arrest

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  Figure 1. Patients with refractory cardiac arrest and extracorporeal cardiopulmonary resuscitation management. Patients with refractory cardiac arrest, who meet eligibility criteria for extracorporeal cardiopulmonary resuscitation (ECPR), may be considered for ECPR to achieve immediate cardiopulmonary stabilization. In contrast, patients who do not fulfil ECPR criteria may be considered for donation after circulatory death with the patient’s advanced directives and the preferences of their relatives. Neurological prognostication should be initiated following ECPR as part of the post-cardiac arrest therapeutic protocol. At 24 h, central nervous system function should be assessed, and in cases where brain death is diagnosed, donation after brain death may be considered in alignment with the patient’s advanced directives and the preferences of their relatives. If central nervous system function is poor or uncertain, a follow-up assessment is conducted after 48 hours (h). However, if cooling is in place at 24 h, completing brain death diagnostics is not feasible at this time point and might be delayed. During the post-cardiac arrest treatment phase, veno-arterial extracorporeal membrane…