Implementation of a regional extracorporeal membrane oxygenation program for out-of-hospital cardiac arrest: results of the prospective observational study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: We implemented a multi-centre extracorporeal cardiopulmonary resuscitation (eCPR) program in a regional emergency medical services (EMS) system and assessed the time-to-cannulation, survival, and neurologic outcomes for patients routed by EMS to eCPR-capable centres. Methods: This was an observational study of patients with out-of-hospital cardiac arrest (OHCA) transported to eCPR-capable centres from July 2020 to September 2024. Patients were routed to an eCPR-capable centre if all applied: age 15-75, refractory/recurrent shockable arrest, a mechanical compression device (MCD) applied, and treatment by a participating EMS unit. Additional patients were routed on clinician judgment. Patients with traumatic arrest, do-not-resuscitate order, known terminal illness, baseline severe neurologic deficit, pregnancy, MCD contraindications, or estimated >30-min transport to an eCPR-capable centre were not routed. The outcomes were survival to hospital discharge (SHD) and neurologic status at discharge. We conducted a logistic regression with inverse-probability weighting to evaluate the association between eCPR and patient outcomes. Results: There were 233 patients routed for eCPR. Median age was 58 years (IQR 48-65), 51 (22 %) were female. Fifty-eight (27 %) were cannulated for eCPR; median time from arrest to cannulation was 66 min (IQR 58-78). Both for all routed patients and among those cannulated, SHD was 27 % and SHD with cerebral performance category (CPC) 1 or 2 was 21 %. In the regression analysis, eCPR was not associated with improved outcomes. Conclusion: In this regional eCPR program, survival among patients refractory to conventional therapy and treated with eCPR was 27%.
Source: Resuscitation Plus
Authors: Nichole Bosson, Juliana Tolles, Clayton Kazan, Stephen Sanko, Tiffany M. Abramson, Marc Eckstein, David Eisner, Joel Geiderman, Walid Ghurabi, Vadim Gudzenko, Anil Mehra, Sam Torbati, Atilla Uner, Amir Abolhoda, Marianne Gausche-Hill, David Shavelle, Adrienne Roel, Ali Nsair, Amar Shah, Amir Abolhada, Andrew Reno, Andrew Wittenberg, Anil Mehra, Anthony Arguija, Atilla Uner, Catherine Borman, Chelsea Davis, Christine Clare, Clayton Kazan, Cora Cuaresma, Danielle Ogaz, Daniel Ramzy, David Hahn, David Hildebrandt, David Shavelle, David Eisner, Denise Whitfield, Emerson Martell, Eric Schmidt, Gene Sung, James Niemann, Jennifer Torres, Joel Geiderman, Juliana Tolles, Kate Hurley, Lauren Spina, Laurie Donegan, Lenny Munari, Leonila Mier, Marc Eckstein, Marianne Gausche-Hill, Matthew Potter, Norm Worcester, Nichole Bosson, Patricia Romero, Paul Vespa, Peter Milano, Peyman Benharash, Raj Makkar, Richard Tadeo, Ryan Burgess, Sam Torbati, Saman Kashani, Samantha Verga-Gates, Sara Rasnake, Sean Stokes, Shahed Toossi, Shane Cook, Stephen Sanko, Tiffany Abramson, Travis Fisher, Vadim Gudzenko, Walid Ghurabi, Weiting Chen
Institutions: Los Angeles County Department of Health Services, University of California, Los Angeles, The Lundquist Institute, Harbor–UCLA Medical Center, University of Southern California, Ronald Reagan UCLA Medical Center, Los Angeles Medical Center, Cedars-Sinai Medical Center, MemorialCare Long Beach Medical Center, Long Beach Medical Center
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,450
OpenAlex ID: W4416589637