Innovative therapy with specially developed small "heart-lung machine" shows significantly better survival and good neurological regeneration. Individual cases successfully treated even after 1-2 hours of resuscitation.

Around 50,000 people suffer a sudden cardiac arrest in Germany every year. If it happens outside a hospital, just one out of ten people survives - often with severe brain damage. With a new treatment method developed at the Medical Center - University of Freiburg, more than three times as many people can be saved in such cases. In addition, those affected often suffer little or no neurological damage. This has now been shown by doctors and researchers of the Medical Center - University of Freiburg, together with colleagues from Germany, Austria and the Netherlands in a clinical, multicentre study involving 69 patients, as presented in the Journal of Clinical Medicine (December 21, 2023).

After decades of research, Freiburg researchers have achieved a breakthrough in emergency medicine with their CARL therapy concept and the new heart-lung machine. CARL stands for Controlled Automated Reperfusion of the whoLe Body.

Until now, there was little hope of survival ten minutes after a cardiac arrest. "With the procedure we have developed, we are significantly extending the time span and improving the recovery of those affected," says Prof. Dr. Georg Trummer, lead author of the study and senior physician at the Department of Cardiovascular Surgery at the Medical Center - University of Freiburg. In the first applications of the new procedure, people who had been in cardiac arrest for more than 60 minutes survived without permanent brain damage. Regardless of this, part of the concept is to treat affected patients as quickly as possible within 30-45 minutes of sudden cardiac arrest using this new procedure.

42 percent survival rate in affected patients

Despite conventional cardiopulmonary resuscitation (CCPR), only 6 - 26 percent of patients survive a cardiac arrest. The Freiburg study now shows an overall survival rate of 42.0 percent on discharge from hospital.

CARL - first resuscitation therapy in all its complexity

"To our knowledge, CARL is the first device that has been specially developed for resuscitation and can, among other things, take over the patient's complete cardiopulmonary function. Above all, however, it is the only device in the world capable of treating the damage caused by cardiac arrest and the associated lack of oxygen. This is possible because we can immediately measure and control all the important parameters, such as blood values, that are necessary for successful resuscitation," says Prof. Dr. Christoph Benk, head of cardiotechnology at the Department of Cardiovascular Surgery at the Medical Center - University of Freiburg.

A unique double pump control system enables the necessary high pulsatile blood flow and achieves a high blood pressure. The oxygen level can be controlled precisely and the patient's body can be cooled down quickly and safely, using a mobile cooling unit. "The size and weight of the device is designed so that it fits in the ambulance and can be carried directly to the patient," explains Prof. Dr. Benk.