We Need a Win: A Panel Discussion Exploring Extracorporeal Cardiopulmonary Resuscitation Implementation Strategies and What Defines Success (Critical Care Interest Group-Sponsored)

Implementing Extracorporeal Cardiopulmonary Resuscitation (ECPR) programs offers a transformative opportunity to improve survival rates for patients who may not survive conventional resuscitation efforts. However, developing and sustaining these programs is more complex than envisioned, requiring careful consideration of institutional structures and resources. This moderated panel discussion will bring together 3-5 experts from academic medical centers and county hospitals to explore different pathways of ECPR implementation. Panelists will address the current status of ECPR programs, focusing on variations between hospital-based and emergency medical services-driven initiatives. Discussions will cover defining success through multidisciplinary collaboration, safe cannulation practices, and key outcome metrics. The panel will also tackle unique barriers related to resources, personnel training, and local regulations, and examine how specialties like emergency medicine and critical care medicine can drive the growth of ECPR programs. Attendees will gain practical insights into overcoming implementation challenges and sustaining these life-saving programs in diverse settings.

Learning Objectives:

Upon completion of this session, participants should be able to:
  • Describe key elements in the design and structure of ECPR programs
  • Evaluate success metrics for ECPR programs
  • Identify and address barriers to ECPR program implementation
  • Discuss the future role of EM and EM/CCM in ECPR growth

Presenters:

  • Ryan J. Buckley, MD
  • Raghu R. Seethala, MD, MSc
  • Anna Condella, MD
  • Nichole Bosson, MD, MPH, NRP
Authors

  • Ryan J. Buckley, MD

    Yale School of Medicine

    Dr. Ryan JJ Buckley, MD, MPH, is an Instructor of Emergency Medicine and Medicine in the Section of Pulmonary, Critical Care, & Sleep Medicine at the Yale School of Medicine. He works clinically in the Emergency Department and Medical Intensive Care Unit at Yale New Haven Hospital. His research aims to improve the care of critically ill patients, and he is uniquely interested in complex substance use disorders during critical illness, focusing on the use of medications for opioid use disorder and complex withdrawal syndromes. He is currently a National Institute on Drug Abuse (NIDA) K12-sponsored Yale-Drug use, Addiction, and HIV prevention Research (DAHRS) Scholar.

  • Raghu R. Seethala, MD, MSc

    Brigham and Women's Hospital / Mass General Brigham

    Dr. Seethala completed his residency in emergency medicine at the Mount Sinai School of Medicine in 2009. He then completed fellowship in Resuscitation Science from Hospital of the University of Pennsylvania in 2010. He pursued further training in critical care and completed Anesthesia Critical Care fellowship at Brigham and Women’s Hospital in 2011. He then joined as faculty at Brigham and Women's Hospital in both Emergency Medicine and Critical Care. Since joining faculty, he has held several leadership positions. From 2018 – 2020, he served as the fellowship director for Emergency Medicine Critical Care. He currently serves as the Chief of the Division of Emergency Critical Care, Medical Director of the ECMO Service, Director of Thoracic Surgical Intensive Care Unit, and co-Director of the Cardiac Surgical Intensive Care Unit.

  • Anna Condella, MD

    University of Washington

    Anna Condella, MD is an emergency medicine physician and intensivist at the University of Washington and a current research fellow in the Cambia Palliative Care Center of Excellence. Dr. Condella’s research interests are in extracorporeal membrane oxygenation (ECMO), critical care resource allocation and health equity. Her recent work has included the publication of a novel framework for examining equity in the use of ECMO and reviewing implementation of extracorporeal resuscitation (ECPR) programs. Her current projects focus on patient factors vulnerable to bias and multidisciplinary clinician experiences in patient selection for ECMO.

  • Nichole Bosson, MD, MPH, NRP

    LA County EMS Agency

    Nichole Bosson MD, MPH, NRP, FAEMS is the Medical Director for the Los Angeles County EMS Agency. She is an Associate Professor of Clinical Emergency Medicine at the David Geffen School of Medicine at UCLA and faculty and EMS fellowship director in the Department of Emergency Medicine at Harbor-UCLA. She is board certified in EMS Medicine and is actively involved in EMS research, education, and policy development. Her research is focused on regional systems of care for time-critical emergencies. She regularly instructs at the J. Michael Criley Paramedic Training Institute. Dr. Bosson is also a certified Urban Search and Rescue (USAR) Medical Team Manager. She deployed with CA-TF2/USA2 to the Nepal, Mexico City and Turkey earthquakes.

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