1, 19, 20, 21
Conventional CPR
Extracorporeal CPR
Only 46/70 (66%) of patients allocated to ECPR were successfully cannulated. Multicentre with variable institutional ECPR experience; long low-flow times.
Refractory out-of-hospital cardiac arrest with an initial shockable rhythm, witnessed, age 18-70
Survival with favourable neurological outcome (CPC 1-2) at 30 days
20% (14/70) vs 16%; OR 1.4 (95% CI 0.5-3.5), p=0.52. 160 randomised, 134 in the primary analysis.
With one third of the intervention arm never cannulated, it tests an ECPR pathway rather than ECPR itself, and cannot exclude benefit in systems with higher cannulation success and shorter time to flow.
In a multicentre setting with mixed institutional experience, an ECPR strategy did not significantly improve 30-day neurologically favourable survival.