2025 Volume 28 Issue 5 Pages 727-734
Aims: There are no specific criteria or protocols for extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA). Our hospital established criteria and protocols to introduce ECPR in August 2018, and in this study, we conducted an investigation on it.
Method: We retrospectively reviewed 57 cases of OHCA in which ECPR was performed at our hospital from August 2018 to March 2023.
Results: At the time of discharge, the survival group included 21 patients (37%) and the good neurological prognosis group included 10 patients (28%). The survival group had more cardiac arrests occurring in public places, more cases of ventricular fibrillation (VF)/pulseless ventricular tachycardia (pVT) at arrival, shorter arrival-to-ECPR and call-to-ECPR times, and better pH and pCO2 values on arrival. Patients in the good neurological prognosis group were younger and had more VF/pVT on arrival, shorter call-to-ECPR times, and better pH and pCO2 values on arrival. In addition, specific actions by emergency technicians (EMTs) lengthened the call-to-arrival time.
Conclusion: Shortening the call-to-ECPR time is important for improving ECPR prognosis. Specific actions by EMTs for VF/pVT on initial electrocardiography lengthen the call-to-arrival time, which is unfavorable. ECPR with a focus on early transport without specific actions by EMTs may lead to improved prognosis.
