A Second Chance for Survival: Clinical Trial Evidence, Eligibility, and Barriers to Implementation of ECPR for Out-of-Hospital Cardiac Arrest.

Abstract

Randomized clinical trials now provide compelling evidence supporting extracorporeal membrane oxygenation-facilitated cardiopulmonary resuscitation (ECPR) for highly selected patients with refractory out-of-hospital cardiac arrest (specifically, initially shockable rhythms, witnessed arrests, and presumed cardiac etiology). ECPR should be considered in centres with experienced ECMO teams. High-performing systems-of-care and institutional commitment are required to implement this logistically and technically complex therapy.