ArticleScandinavian journal of trauma, resuscitation and emergency medicine2020
Out-of-hospital cardiac arrest patients with an initial non-shockable rhythm could be candidates for extracorporeal cardiopulmonary resuscitation: a retrospective study.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 33 citations in OpenAlex.
- Impact of transient return of spontaneous circulation and downtime on neurological outcomes following extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest: a single-center retrospective study.BMC cardiovascular disorders · 2026Article
- Clinical Prediction Score for Patients With Initial Nonshockable Rhythm Receiving Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest: Development and Internal Validation.Journal of the American Heart Association · 2025Observational
- The influence of preexisting coronary artery disease on long-term follow up and neurological outcome in patients receiving out of hospital extracorporeal membrane oxygenation.Resuscitation plus · 2025Article
- Article
- Extracorporeal Membrane Oxygenation for Pulmonary Embolism: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Application of the TiPS65 score for out-of-hospital cardiac arrest patients with initial non-shockable rhythm treated with ECPR.Resuscitation plus · 2023Article
- Benefits, key protocol components, and considerations for successful implementation of extracorporeal cardiopulmonary resuscitation: a review of the recent literature.Clinical and experimental emergency medicine · 2023Article
- Extracorporeal cardiopulmonary resuscitation for adult out-of-hospital cardiac arrest patients: time-dependent propensity score-sequential matching analysis from a nationwide population-based registry.Critical care (London, England) · 2023Article
- Article
- Knowledge gaps and research priorities in adult veno-arterial extracorporeal membrane oxygenation: a scoping review.Intensive care medicine experimental · 2022Article
- A novel extracorporeal cardiopulmonary resuscitation strategy using a hybrid emergency room for patients with pulseless electrical activity.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Extracorporeal cardiopulmonary resuscitation in adult patients with out-of-hospital cardiac arrest: a retrospective large cohort multicenter study in Japan.Critical care (London, England) · 2022Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtracorporeal cardiopulmonary resuscitation (ECPR) is a promising treatment for refractory out-of-hospital cardiac arrest (OHCA). Most studies evaluating the effectiveness of ECPR include patients with an initial shockable rhythm. However, the effectiveness of ECPR for patients with an initial non-shockable rhythm remains unknown. This retrospective single-center study aimed to evaluate the effectiveness of ECPR for patients with an initial non-shockable rhythm, with reference to the outcomes of OHCA patients with an initial shockable rhythm.
methodsAdult OHCA patients treated with ECPR at our center during 2011-2018 were included in the study. Patients were classified into the initial shockable rhythm group and the non-shockable rhythm group. The primary outcome was the cerebral performance category (CPC) scale score at hospital discharge. A CPC score of 1 or 2 was defined as a good outcome.
resultsIn total, 186 patients were eligible. Among them, 124 had an initial shockable rhythm and 62 had an initial non-shockable rhythm. Among all patients, 158 (85%) were male, with a median age of 59 (interquartile range [IQR], 48-65) years, and the median low flow time was 41 (IQR, 33-48) min. Collapse was witnessed in 169 (91%) patients, and 36 (19%) achieved return of spontaneous circulation (ROSC) transiently. Proportion of female patients, presence of bystander cardiopulmonary resuscitation, and collapse after the arrival of emergency medical service personnel were significantly higher in the non-shockable rhythm group. The rate of good outcomes at hospital discharge was not significantly different between the shockable and non-shockable groups (19% vs. 16%, p = 0.69). Initial shockable rhythm was not significantly associated with good outcome after controlling for potential confounders (adjusted odds ratio 1.58, 95% confidence interval: 0.66-3.81, p = 0.31). In the non-shockable group, patients with good outcomes had a higher rate of transient ROSC, and pulmonary embolism was the leading etiology.
conclusionsThe outcomes of patients with an initial non-shockable rhythm are comparable with those having an initial shockable rhythm. OHCA patients with an initial non-shockable rhythm could be candidates for ECPR, if they are presumed to have reversible etiology and potential for good neurological recovery.
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