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Impact of rapid response car system on ECMO in out-of-hospital cardiac arrest

Published:April 07, 2018DOI:https://doi.org/10.1016/j.ajem.2018.03.062
      I read with great interest the recent article by Sato et al. [
      • Sato R.
      • Kuriyama A.
      • Nasu M.
      • Gima S.
      • Iwanaga W.
      • Takada T.
      • et al.
      Impact of rapid response car system on ECMO in out-of-hospital cardiac arrest: a retrospective cohort study.
      ]. The authors examined the effect of physician-based emergency medical services (P-EMS) that use a rapid response car (RRC) on the time from arrival to the implementation of extracorporeal membrane oxygenation (ECMO; door-to-ECMO). They concluded that the physician-based RRC system was associated with a shorter door-to-ECMO time and that the combination of an RRC system with extracorporeal life support (ECLS) may lead to better outcomes in patients with out-of-hospital cardiac arrest (OHCA). However, this conclusion is overstated, and several issues in this study need to be confirmed.
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