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Authors’ response: Extracorporeal cardiopulmonary resuscitation probably good, but adoption should not be too fast and furious!
  1. Brian Burns1,
  2. Cliff Reid2,
  3. Rob Scott3,
  4. Stephen Bernard4,
  5. Lionel Lamhaut5,
  6. Joe Bellezzo6,
  7. Zack Shinar7,
  8. Mark Dennis8,
  9. Paul Forrest9
  1. 1Pre-hospital care, Greater Sydney Area HEMS, Bankstown, New South Wales, Australia
  2. 2New South Wales Ambulance, Greater Sydney Area HEMS, Bankstown, New South Wales, Australia
  3. 3Greater Sydney Area HEMS, Ambulance Service of New South Wales, Rozelle, New South Wales, Australia
  4. 4Alfred Hospital and DEPM, Monash University, Melbourne, Victoria, Australia
  5. 5DAR – SAMU de Paris CHU Necker INSERM U 970 "Centre d'Expertise de la Mort Subite", Paris, France
  6. 6Emergency Department, Sharp Memorial Hospital, San Diego, California, USA
  7. 7Department of Emergency Medicine, Sharp Memorial Hospital, San Diego, California, USA
  8. 8Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  9. 9Cardiothoracic Anaesthesia and Perfusion, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  1. Correspondence to Dr Brian Burns, Pre-hospital care, Greater Sydney Area HEMS, Bankstown, New South Wales, Australia; bburns_2000{at}yahoo.com

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Callaway and Sunde1 are right when they advise caution in adoption of extracorporeal cardiopulmonary resuscitation (ECPR) given the varying definitions of what ECPR constitutes. However, we believe ECPR is not coming ‘too fast and furious’ but rather like a Formula One car, dependent on focused high performance teams, bespoke with narrow specifications and at the cutting edge.

Current survival for cardiac arrest by conventional cardiopulmonary resuscitation (CCPR) is indeed dismal at around 10%.2 ECPR has led to improved outcomes compared with CCPR in many regions.3–6 ECPR consideration is in some ways analogous to resuscitative thoracotomy (RT) in trauma. Despite moderate quality of evidence, RT is strongly recommended in pulseless penetrating torso trauma with signs of life in ED.7 …

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