Cardiology in critical care · Extracorporeal CPR
Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest
| Design | Multicentre randomised controlled trial |
|---|---|
| Treatment | Extracorporeal cardiopulmonary resuscitation |
| Control | Conventional cardiopulmonary resuscitation |
| Population | 134 analysed patients with refractory out-of-hospital cardiac arrest, of 160 randomised |
| Follow-up | 30 days |
| Primary endpoint | Survival with a favourable neurological outcome at 30 days |
| Result | 70 patients were assigned to extracorporeal CPR and 64 to conventional CPR, with 26 excluded for not meeting inclusion criteria at hospital admission. Survival with favourable neurological outcome was similar between strategies. |
| Secondary endpoints | 30-day and 6-month survival, complications |
In patients with refractory out-of-hospital cardiac arrest, extracorporeal CPR and conventional CPR had similar effects on survival with a favorable neurologic outcome.
The trial authors, in the published abstract
Pragmatic and multicentre, and therefore more representative than the single high-volume-centre series that generated enthusiasm for extracorporeal CPR. Whether the intervention fails or the logistics do — time to cannulation is everything — remains contested.
Suverein MM, Delnoij TSR, Lorusso R, et al. Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. N Engl J Med 2023 Jan 26;388(4):299-309.