eCPR — AUTOMATIC CONTROLLED REPERFUSION
CARL.
The world's first mobile ECMO system for automatic controlled reperfusion after cardiac arrest. Resuscitec CARL combines the pump, oxygenation, hypothermia and blood-gas analysis in a single portable platform — for maximum neurological outcomes in advanced resuscitation.
Model: Resuscitec CARL
WHAT CARL MEANS
Automatic controlled whole-body reperfusion
Conventional reperfusion after cardiac arrest simply restarts circulation — that's all. CARL controls the initial reperfusion conditions to limit ischemia/reperfusion injury, automatically managing — in the first critical minutes — the pressure, pulsatility, oxygen content, pH, temperature, calcium and osmolarity of the reperfusion blood.
- High pulsatile flow — reopens the capillary bed
- Immediate mild hypothermia (~34 °C) — reduces metabolic demand
- Hyperosmolar blood (Na⁺, albumin, mannitol) — limits cerebral edema
- Citrate — prevents cellular Ca²⁺ overload
- pH-stat strategy with controlled CO₂
- Titrated O₂ 21–100% — reduces free radicals (ROS)
VIDEO
A new chain of survival — CARL in action
THE CARL PLATFORM
Four modules integrated into a single system
CARL is not a single pump but a complete platform: hemodynamic control, oxygenation independent of compressed air, instant chemical cooling and a dedicated simulator for team training.
CONTROLLER
CARL. Controler
The "brain" of the system — a portable controller with two pumps, continuous arterial and venous blood-gas analysis and high pulsatile flow under closed-loop physiological control.
- Two pumps with 0–8 L/min flow, pulsatile
- 4 pressure channels (3 on the circuit + 1 aortic)
- Hb, SvO₂ and venous T continuously (integrated venous analysis)
- 25 arterial blood-gas (ABG) measurements at 1.5 / 3 / 5 min
- 8.4″ touchscreen + backup LCD display
- Two Li-ion batteries, ~3h each
OXYGENATION
CARL. MOX
A mobile oxygenation module, completely independent of compressed medical air. It mixes ambient air with O₂ from a cylinder to deliver precisely controlled gas exchange in any location — ambulance, helicopter, ward.
- Adjustable FiO₂ 21% – 100%
- Gas flow up to 12 L/min
- Works without compressed medical air
- Internal blower + ambient air + external O₂ cylinder
- ~4h battery life for pre-hospital use
- Enables the pH-stat strategy without hyperoxia
HYPOTHERMIA
CARL. Răcitor
A mobile hypothermia unit with no electrical power needed for the cooling reaction. It uses the endothermic dissolution of urea in water to lower the extracorporeal circuit temperature by ~4 °C within minutes.
- Δ 4 °C at the heat exchanger within minutes
- Patient target ~34 °C (mild hypothermia)
- Chemical principle, no compressor or electricity
- Immediate cooling from the moment of cannulation — not delayed
- Compact, transport-ready, integrated into the CARL set
- Indicated for pre-hospital OHCA and transport
TRAINING SIMULATOR
CARL. SAM
A portable, easy-to-set-up simulator for training eCPR teams. A manikin with an integrated chest-compression mechanism and ultrasound-guided cannulation sites — it allows the CARL protocol to be rehearsed in under 5 minutes from startup.
- Assembly < 5 min, disassembly < 5 min
- 2 cannulation zones (left + right femoral)
- Ultrasound-guided cannulation — realistic vessels
- Integrated chest-compression mechanism
- Palpable pulse simulation; fluid capacity ~2.5 L
- Rigid transport case included
CLINICAL INDICATIONS
Where CARL makes the difference
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Refractory cardiac arrest (OHCA / IHCA)
Extracorporeal resuscitation (eCPR) when conventional CPR fails to achieve return of spontaneous circulation (ROSC). Indicated in refractory cardiac arrest, pre-hospital or in-hospital.
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Prolonged CPR — over 60 minutes
Clinically documented: neurologically intact survival after 120 min of quality CPR. Resuscitec shows that "too late" is no longer the same threshold.
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Refractory ventricular fibrillation
A hemodynamic bridge for patients with VF refractory to repeated defibrillation and pharmacological support. It enables stabilisation until PCI.
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Emergency room, Cath lab, ICU
ECMO initiation directly at the bedside, in the cath lab or in the intensive care unit. A mobile system — no need to move the patient.
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EMS — ambulance and helicopter
It runs on battery, without compressed medical air. CARL can be deployed at the scene and kept active throughout the inter-hospital transfer.
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eCPR training programs
CARL Academy + the SAM simulator allow interdisciplinary teams to reach competence for real clinical use — cannulation, circuit priming, reperfusion initiation.
DE CE CARL
A system designed for the neurological outcome, not just for ROSC
Conventional ECMO can save the heart but not the brain. What sets CARL apart is its controlled-reperfusion protocol — every physiological parameter is adjusted automatically in the first critical minutes, when ischemia/reperfusion injury makes the biggest difference to neurologically intact survival.
- CE marked since 2020 — used in European reference centres
- Prix Galien USA 2025 award for medical innovation
- Developed at Freiburg University Hospital (Trummer & Beyersdorf)
- Integrated mobile system — controller + oxygenator + cooler + simulator
- Used pre-hospital, in transport and in-hospital — one single system
Interested in the CARL system?
The Hellimed team provides technical consulting, demonstrations, training through CARL Academy and custom configurations for ICU, interventional cardiology and emergency services.
Request a quote for CARL