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EMCrit Wee – Controlled Automated Reperfusion of the Whole Body (CARL) ECPR / ECLS Yields Amazing Results

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Today, we talk about a paper that showed impressive neurologically intact survival for all-rhythms presenting in cardiac arrest, both OHCA and IHCA. It uses a new set of strategies and technologies called CARL.

 

The Paper

Review Paper

 

Freidhelm Beyersdorf

Bio for Dr. Beyersdorf

COI

Dr. Beyersdorf is the founder and a current shareholder of Resuscitech, the parent company of the CARL System

 

CARL Circuit

Eight Differences of the CARL Strategy

  1. Cytoprotective Perfusate Prime (see below)
  2. Pulsatile Flow – using 2 pumps in the circuit
  3. Multi-Organ Repair Strategy
  4. High-Flow/High Pressure Strategy
  5. Immediate Hypothermia to 32-33 C
  6. Real-Time Monitoring
  7. Portable System
  8. Mandatory Distal-Limb Perfusion

Priming Perfusate

Some of the Multi-Organ Repair Strategy

JTCVS Open. 2021 Dec; 8: 47–52.
  • See the supplemental material above for the whole strategy

Real-Time Monitoring

Real-time monitoring of hemodynamic parameters (cardiac output, heart rate, and blood pressure), venous and arterial blood gases (pO2 and pH), electrolytes (calcium, potassium, and sodium), and venous blood temperature was implemented to achieve the necessary personalized treatment for multiorgan repair (10.3390/jcm13010056)

Additional New Information

 

More on EMCrit

Now on to the Wee

Scott Weingart, MD FCCM
Latest posts by Scott Weingart, MD FCCM (see all)

Cite this post as:

Scott Weingart, MD FCCM. EMCrit Wee – Controlled Automated Reperfusion of the Whole Body (CARL) ECPR / ECLS Yields Amazing Results. EMCrit Blog. Published on June 3, 2024. Accessed on April 26th 2025. Available at [https://emcrit.org/emcrit/emcrit-wee-controlled-automated-reperfusion-of-the-whole-body-carl-ecpr-ecls-yields-amazing-results/ ].

Financial Disclosures:

The course director, Dr. Scott D. Weingart MD FCCM, reports no relevant financial relationships with ineligible companies. This episode’s speaker(s) report no relevant financial relationships with ineligible companies unless listed above.

CME Review

Original Release: June 3, 2024
Date of Most Recent Review: Jul 1, 2024
Termination Date: Jul 1, 2027

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Christopher Ray
Christopher Ray
10 months ago

Last two episodes have been over the top great. I am intrigued by the priming solution and pulsatile flow; makes sense. Planning a deep dive into this solution, cant wait to read the paper.

What's Your Job?
AGACNP CVICU/ECMO/SICU
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Christopher Elliott
Christopher Elliott
1 month ago

Great post! Block Blast Unblocked

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