24, 23, 74
The commonest recorded reason for stopping ECPR is a neurological prognosis and the commonest day for it is the first - which cannot be reconciled with Chapter 23's finding that the prognostic clock starts at sedation clearance and that half of patients remain indeterminate at 72 hours. Either these decisions rest on grounds other than those recorded, or on grounds the evidence does not support; the registry cannot distinguish them.
Patients without such a decision
DOI 10.1186/s13054-023-04534-2
Prevalence, recorded reasons and timing of decisions to withhold or withdraw life-sustaining therapy
Registry, retrospective, recorded reason only; one national practice culture. The same analysis is reported twice by these authors with different denominators (1,660 and 510 against 1,651 and 506; reason denominators 510 against 477) - the fourth same-authors-different-numbers instance in Part IV. Structured abstract only. [VERIFICATION REQUIRED]
510 patients (30.7%) had a withdrawal decision. The number was highest on the first day and the median was two days after intensive care admission. Reasons: perceived unfavourable neurological prognosis 300/510 (58.8%); perceived unfavourable cardiac or pulmonary prognosis 105/510 (20.5%); inability to maintain extracorporeal support 71/510 (13.9%); complications 10 (1.9%); exacerbation of comorbidity 7 (1.3%). Thirty-day survival 36/506 (7.1%) with a decision against 386/1140 (33.8%) without.
1,660 adults undergoing ECPR for out-of-hospital cardiac arrest of medical cause, Japanese multicentre registry