Mechanical circulatory support for refractory out-of-hospital cardiac arrest: a nationwide multicentre study

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) has shown potential as a salvage therapy for patients with refractory out-of-hospital cardiac arrest (OHCA). Despite growing interest in and body of literature on ECPR OHCA, robust evidence patient eligibility is still lacking. Purpose To describe the survival, neurological outcome, adherence to national consensus respect use identify factors associated outcome. Methods Retrospective, observational cohort study who underwent OHCA at four centres. Binary logistic regression Kaplan-Meier survival curves were performed assess association 30-day mortality. Results A total 259 receiving between July 2011 December 2020 included study. Thirty-day was 26% good outcome Cerebral Performance Category (CPC) 1–2 observed 94% discharge. Strict showed rate 30%. Adding one or more following criteria consensus: signs life during (CPR), pre-hospital low-flow <100 minutes, pH >6.8 lactate <15 mmol/L increased 48%, but would exclude 58% survivors from current cohort. Logistic identified initial presenting rhythm asystole (RR 1.36, 95% CI 1.18–1.57), pulseless electrical activity (PEA) 1.20, 1.03–1.41), <6.8 1.28, 1.12–1.46) levels >15 1.16, 1.16–1.53) risk Patients CPR had threefold higher than without (45% versus 13%, p<0.001) Conclusion high this population treated OHCA. Signs may aid decision-making selection appropriate candidates. Stringent produce rates potentially withholds life-saving treatment significant proportion survivors, why optimization necessary. FUNDunding Acknowledgement Type funding sources: Foundation. Main source(s): This work supported by Danish Heart Foundation [20-R142-A9498-22178]; Health Research Central Denmark Region [R64-A3178-B1349] Survival