Johannes F H Ubben, Samuel Heuts, Thijs S R Delnoij, Martje M Suverein, Anina F van de Koolwijk, Iwan C C van der Horst, Jos G Maessen, Jason Bartos, Petra Kavalkova, Daniel Rob, Demetris Yannopoulos, Jan Bělohlávek, Roberto Lorusso, Marcel C G van de Poll

Extracorporeal cardiopulmonary resuscitation for refractory OHCA: lessons from three randomized controlled trials—the trialists’ view

  • Cardiology and Cardiovascular Medicine
  • Critical Care and Intensive Care Medicine
  • General Medicine
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Abstract Extracorporeal cardiopulmonary resuscitation is a promising treatment for refractory out-of-hospital cardiac arrest. Three recent randomized trials (ARREST trial, Prague OHCA study, and INCEPTION trial) that addressed the clinical benefit of extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest yielded seemingly diverging results. The evidence for extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest, derived from three recent randomized controlled trials, is not contradictory but rather complementary. Excellent results can be achieved with a very high level of dedication, provided that strict selection criteria are applied. However, pragmatic implementation of extracorporeal cardiopulmonary resuscitation does not necessarily lead to improved outcome of refractory out-of-hospital cardiac arrest. Centres that are performing extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest or aspire to do so should critically evaluate whether they are able to meet the pre-requisites that are needed to conduct an effective extracorporeal cardiopulmonary resuscitation programme.

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