ECPR can be used as a salvage therapy for refractory cardiac arrest that does not respond to conventional Advanced Cardiac Life Support (ACLS) therapies. It is a time-critical and complex therapy that requires teamwork, clearly defined roles, and training to achieve successful outcomes.
ECPR can be deployed for both in-hospital and out-of-hospital cardiac arrest patients. For those patients that are considered candidates for ECPR, expected survival to hospital discharge for in-hospital cardiac arrest is around 40%, whilst out-of-hospital cardiac arrest survival salvaged with ECPR is about 20%. In survivors, the neurological outcomes generally fall into CPC categories 1 or 2. [1,2]
[1] Stub, D. et al. Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation 86, 88–94 (2015). [PMID25281189]
[2] Patricio, D. et al. Comparison of extracorporeal and conventional cardiopulmonary resuscitation: a retrospective propensity score matched study. Crit Care 23, 27 (2019). [PMID30691512]