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We agree with most points made by Burns and colleagues.1 In fact, their letter is an excellent example of the enthusiasm that surrounds extracoporeal cardiopulmonary resuscitation (ECPR), and that is essential to bring novel approaches to resuscitation. Their own data and experience reinforce the impression that mechanical cardiac support may benefit some patients after cardiac arrest. In addition, it is clear that ECPR, if it is deployed, should be part of optimising the entire system of emergency care. Doing system-wide optimisation will benefit the majority …
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