ArticleResuscitation2022
Early withdrawal of life sustaining therapy in extracorporeal cardiopulmonary resuscitation (ECPR): Results from the Extracorporeal Life Support Organization registry.
Article in Resuscitation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Neurological outcome predictors after extracorporeal cardiopulmonary resuscitation: a systematic review.Systematic reviews · 2025Pooled it
- Organ Donor Potential After Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest: A Post-Hoc Analysis of a Randomized Controlled Trial.Clinical transplantation · 2025Trial
- Neuroprognostication After Extracorporeal Cardiopulmonary Resuscitation: ECMO-Specific Challenges and a Multimodal Time-Sensitive Framework.Journal of cardiovascular development and disease · 2026Review
- Navigating the Evidence Gap: Expert Consensus as a Bridge to Research in Extracorporeal Cardiopulmonary Resuscitation for Adults.Journal of the American Heart Association · 2026Article
- Recommendations in Extracorporeal Cardiopulmonary Resuscitation Post Resuscitation Care Via An International, Modified Delphi Approach.Journal of the American Heart Association · 2026Review
- Low-flow time and neurological outcomes in AMI patients undergoing ECPR: a retrospective cohort study.Frontiers in cardiovascular medicine · 2026Article
- Navigating end-of-life decision-making on ECLS discontinuation in children: insights from the international ENSURE survey.European journal of pediatrics · 2025Article
- International Consensus on Evidence Gaps and Research Opportunities in Extracorporeal Cardiopulmonary Resuscitation for Refractory Out-of-Hospital Cardiac Arrest: A Report From the National Heart, Lung, and Blood Institute Workshop.Journal of the American Heart Association · 2025Review
- Article
- Association between pupillary examinations and prognosis in patients with out-of-hospital cardiac arrest who underwent extracorporeal cardiopulmonary resuscitation: a retrospective multicentre cohort study.Annals of intensive care · 2024Article
- Extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest: 10-year experience in a metropolitan cardiac arrest centre in Milan, Italy.Resuscitation plus · 2024Article
- The Role of Palliative Care Consultation in Withdrawal of Life-Sustaining Treatment among ICU Patients Receiving Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO): A Retrospective Case-Control Study.The American journal of hospice & palliative care · 2024Observational
- Predicting Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation Patients with Tree-Based Machine Learning: Analysis of the Extracorporeal Life Support Organization Registry.Research square · 2024Article
- Extracorporeal Membrane Oxygenation.Respiratory care · 2023Review
- Prevalence, reasons, and timing of decisions to withhold/withdraw life-sustaining therapy for out-of-hospital cardiac arrest patients with extracorporeal cardiopulmonary resuscitation.Critical care (London, England) · 2023Article
- Hypoxic-Ischemic Brain Injury in ECMO: Pathophysiology, Neuromonitoring, and Therapeutic Opportunities.Cells · 2023Review
- Extracorporeal Cardiopulmonary Resuscitation: A Narrative Review and Establishment of a Sustainable Program.Medicina (Kaunas, Lithuania) · 2022Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
aimsAlthough extracorporeal cardiopulmonary resuscitation (ECPR) improves survival outcomes in refractory cardiac arrest, morbidity and mortality remain significantly high. Information on causes of death in ECPR is limited; however, some evidence suggests withdrawal of life sustaining therapy (WLST) is a major factor in ECPR-associated mortality. We sought to describe the patients experiencing WLST after ECPR.
methodsThe international Extracorporeal Life Support Organization (ELSO) Registry was retrospectively queried for patients more than 18 years old supported with ECPR who underwent WLST due to family request from 2007 to 2017. These patients were split into groups for descriptive and multivariable analysis: early (WLST < 72 hours from cannulation) and routine WLST.
resultsOverall, 411 ECPR patients experienced WLST (median age 42 years IQR = 28-51; 31.7% female) over the 10-year period. 55.5% (n = 228) underwent early WLST with a median ECPR duration of 24 hours (IQR = 7-48) versus routine WLST (median = 147 hours; IQR = 105-238). In multivariable regression analysis, lower arterial blood gas pH (aOR = -3.1; 95% CI = 2.18-2.8; p = 0.04), arterial oxygen saturation (aOR = 1.12; 95% CI = 1.01-1.23; p = 0.02), and higher peak inspiratory pressure (aOR = 0.84; 95% CI = 0.71-1.00; p = 0.05) were independently associated with early WLST. Early WLST patients experienced higher rates of all ECMO-related complications except for infections.
conclusionsMore than half of ECPR patients experienced early WLST within 72 hours. The patients with early WLST had worse markers of severe critical illness at 24 hours and experienced higher rates of complications. Further research should include an appropriate control group to better adjust confounders for ECPR-associated death and focus on prognostication.
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Registered trials
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