Evidence map›Paper›PMID 33541748›Full record

Trial reportAnnals of emergency medicine2021

Extracorporeal Cardiopulmonary Resuscitation for Refractory Out-of-Hospital Cardiac Arrest (EROCA): Results of a Randomized Feasibility Trial of Expedited Out-of-Hospital Transport.

Cindy H Hsu, William J Meurer, Robert Domeier, Jennifer Fowler, Sage P Whitmore, Benjamin S Bassin, Kyle J Gunnerson, Jonathan W Haft, William R Lynch, Brahmajee K Nallamothu and 6 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 4 pooled it
20.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 4 syntheses or guidelines pooled it, 110 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Guideline
  4. Extracorporeal membrane oxygenation for critically ill adults.The Cochrane database of systematic reviews · 2023
    Pooled it
  5. Trial
  6. Review
  7. Article
  8. Article
  9. Article
  10. Determining Access for a City-Wide Extracorporeal Cardiopulmonary Resuscitation (ECPR) Initiative Using Geospatial Analysis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026
    Article
  11. Review
  12. Article
  13. Review
  14. Review
  15. Review
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

Cindy H HsuDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI; Michigan Center for Integrative Research in Critical Care, University of Michigan Medical School, Ann Arbor, MI; Department of Surgery, University of Michigan Medical School, Ann Arbor, MI. Electronic address: hcindy@med.umich.edu.
William J MeurerDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI; Michigan Center for Integrative Research in Critical Care, University of Michigan Medical School, Ann Arbor, MI; Department of Neurology, University of Michigan Medical School, Ann Arbor, MI.
Robert DomeierDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI; Saint Joseph Hospital, University of Michigan Medical School, Ann Arbor, MI.
Jennifer FowlerDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI.
Sage P WhitmoreDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI.
Benjamin S BassinDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI; Michigan Center for Integrative Research in Critical Care, University of Michigan Medical School, Ann Arbor, MI.
Kyle J GunnersonDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI; Michigan Center for Integrative Research in Critical Care, University of Michigan Medical School, Ann Arbor, MI.
Jonathan W HaftDepartment of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, MI.
William R LynchDepartment of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, MI.
Brahmajee K NallamothuDepartment of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI.
Renee A HaveyDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI.
Kelley M KidwellDepartment of Biostatistics, University of Michigan Medical School, Ann Arbor, MI.
William C StaceyExtracorporeal Life Support Laboratory, University of Michigan Medical School, Ann Arbor, MI.
Robert SilbergleitDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI.
Robert H BartlettDepartment of Surgery, University of Michigan Medical School, Ann Arbor, MI; Extracorporeal Life Support Laboratory, University of Michigan Medical School, Ann Arbor, MI.
Robert W NeumarDepartment of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI; Michigan Center for Integrative Research in Critical Care, University of Michigan Medical School, Ann Arbor, MI; Extracorporeal Life Support Laboratory, University of Michigan Medical School, Ann Arbor, MI.
University of Michigan–Ann Arbor · US

Funding

Michigan Institute for Clinical and Health Research (MICHR)UL1TR002240 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LUMENG, JULIE C, MASHOUR, GEORGE ALEXANDER · 2017 to 2022
$54.9M
K12: Career Development in Emergency Critical Care ResearchK12HL133304 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI NEUMAR, ROBERT W., PINSKY, DAVID J. · 2016 to 2020
$2.2M
Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest (EROCA) Trial Planning GrantR34HL130738 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BARTLETT, ROBERT H., NEUMAR, ROBERT W. · 2016 to 2017
$698k
NCATS NIH HHS UL1 TR002240NHLBI NIH HHS K12 HL133304NHLBI NIH HHS R34 HL130738
6 · The paper itself

Abstract

STUDY

objectiveOutcomes of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest depend on time to therapy initiation. We hypothesize that it would be feasible to select refractory out-of-hospital cardiac arrest patients for expedited transport based on real-time estimates of the 911 call to the emergency department (ED) arrival interval, and for emergency physicians to rapidly initiate ECPR in eligible patients.

methodsIn a 2-tiered emergency medical service with an ECPR-capable primary destination hospital, adults with refractory shockable or witnessed out-of-hospital cardiac arrest were randomized 4:1 to expedited transport or standard care if the predicted 911 call to ED arrival interval was less than or equal to 30 minutes. The primary outcomes were the proportion of subjects with 911 call to ED arrival less than or equal to 30 minutes and ED arrival to ECPR flow less than or equal to 30 minutes.

resultsOf 151 out-of-hospital cardiac arrest 911 calls, 15 subjects (10%) were enrolled. Five of 12 subjects randomized to expedited transport had an ED arrival time of less than or equal to 30 minutes (overall mean 32.5 minutes [SD 7.1]), and 5 were eligible for and treated with ECPR. Three of 5 ECPR-treated subjects had flow initiated in less than or equal to 30 minutes of ED arrival (overall mean 32.4 minutes [SD 10.9]). No subject in either group survived with a good neurologic outcome.

conclusionThe Extracorporeal Cardiopulmonary Resuscitation for Refractory Out-of-Hospital Cardiac Arrest trial did not meet predefined feasibility outcomes for selecting out-of-hospital cardiac arrest patients for expedited transport and initiating ECPR in the ED. Additional research is needed to improve the accuracy of predicting the 911 call to ED arrival interval, optimize patient selection, and reduce the ED arrival to ECPR flow interval.

Indexed as

Emergency Medical ServicesCardiopulmonary ResuscitationEmergency Service, HospitalFeasibility StudiesFemaleHumansMaleMichiganMiddle AgedOut-of-Hospital Cardiac ArrestTime-to-Treatment

Identifiers

PMID33541748
PMCPMC8238799
OpenAlexW3127137937

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.