Two-year survival and neurological outcome of in-hospital cardiac arrest patients rescued by extracorporeal cardiopulmonary resuscitation

Saving life and brain with extracorporeal cardiopulmonary resuscitation: A single-center analysis of in-hospital cardiac arrests

“…This leads to limitations as to when E-CPR can be performed due to variable availability of attending physicians, perfusionists and ECMO circuits. This is a setting that differs from that described in a number of previous reports on E-CPR [8][9][10]. Ideally, our E-CPR sample could have been compared to an internal control group, but our hospital CPR records are incompletely documented, and the CPR patient population differed from ours.…”

“…ECMO treatment has been associated with the risk of neurological complications, with E-CPR raising that risk even further [21][22]. Prior studies have compared the efficacy of E-CPR to conventional CPR in preventing long-term neurological damage, and have shown that E-CPR is significantly better at neurological protection than conventional CPR [9]. Recently, a single center observational study assessing the use of aggressive E-CPR combined with hypothermia for cardiac arrest patients demonstrated similar results of full neurological recovery for the E-CPR survivors [28].…”

“…Further studies on E-CPR have shown an increased rate of survival at 1-year [8], and 2-years [9] after discharge when compared to conventional CPR. Many of these studies on adult E-CPR have taken place under optimal conditions in institutions that have designated teams of E-CPR specialists, ready to cannulate patients as a part of the Code Team [8][9][10].…”

Meta-analysis on extracorporeal life support during cardiac arrest: do not compare apples and oranges

“…In this setting, Ouweneel et al gathered these heterogeneous studies and their meta-analysis brings new insights although no prospective randomized controlled trials exist yet. They selected nine retrospective studies (4,(7)(8)(9)(10)(11)(12)(13)(14), comparing E-CPR vs. conventional CPR (C-CPR), resulting in a total of 3.098 patients (708 ECLS vs. 2.390 control). Outcomes were 30-day survival rate and favorable neurological outcomes [Glasgow-Pittsburgh cerebralperformance categories (CPC) score of 1 or 2] at 30 days evaluated by total cohort and propensity-matched cohort analysis (when available).…”

“…Herein, 438 and 195 patients were matched for 30-day survival and neurological outcome evaluation, respectively (4,7,9,11,14). Despite a major reduction in the number of included patients, results remain in favor of E-CPR group for both 30-day survival rates (risk difference 14%; 95% CI 2-25%; P=0.02; number needed to treat 7.1) and favorable neurological outcome (risk difference 13%; 95% CI 7-20%; P=0.0001; NNT 7.7) ( Table 1).…”