Evidence map›Paper›PMID 36566221›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2022

Improving access to extracorporeal membrane oxygenation for out of hospital cardiac arrest: pre-hospital ECPR and alternate delivery strategies.

Changle Song, Mark Dennis, Brian Burns, Sophie Dyson, Paul Forrest, Mahesh Ramanan, David Levinson, Emily Moylan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
7.4field-weighted citation impact, top 2% 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

17 citing papers in PubMed, 33 citations in OpenAlex.

  1. Article
  2. Article
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  5. 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
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  8. Review
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  11. A case of intraoperative arrest & mobile ECMO.The journal of extra-corporeal technology · 2025
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  12. Article
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  14. Review
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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

8 authors at 3 institutions in 1 country.

Changle SongSchool of Civil Engineering, The University of Sydney, Sydney, NSW, 2006, Australia.
Mark DennisFaculty of Medicine and Health, The University of Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0002-1281-1324
Brian BurnsFaculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Sophie DysonNSW Ambulance, Sydney, Australia.
Paul ForrestFaculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Mahesh RamananPrince Charles Hospital, Brisbane, QLD, Australia.
David LevinsonSchool of Civil Engineering, The University of Sydney, Sydney, NSW, 2006, Australia.
Emily MoylanSchool of Civil Engineering, The University of Sydney, Sydney, NSW, 2006, Australia. emily.moylan@sydney.edu.au.ORCID http://orcid.org/0000-0003-1680-6407
The University of Sydney · AUNSW Ambulance · AUThe University of Queensland · AU

Funding

National Heart Foundation of Australia 105849NSW Ministry of Health Translational Grant Scheme
6 · The paper itself

Abstract

backgroundThe use of extracorporeal membrane oxygenation (ECPR) in refractory out-of-hospital cardiac arrest (OHCA) patients is usually implemented in-hospital. As survival in ECPR patients is critically time-dependent, alternative models in ECPR delivery could improve equity of access.

objectivesTo identify the best strategy of ECPR delivery to provide optimal patient access, to examine the time-sensitivity of ECPR on predicted survival and to model potential survival benefits from different delivery strategies of ECPR.

methodsWe used transport accessibility frameworks supported by comprehensive travel time data, population density data and empirical cardiac arrest time points to quantify the patient catchment areas of the existing in-hospital ECPR service and two alternative ECPR strategies: rendezvous strategy and pre-hospital ECPR in Sydney, Australia. Published survival rates at different time points to ECMO flow were applied to predict the potential survival benefit.

resultsWith an in-hospital ECPR strategy for refractory OHCA, five hospitals in Sydney (Australia) had an effective catchment of 811,091 potential patients. This increases to 2,175,096 under a rendezvous strategy and 3,851,727 under the optimal pre-hospital strategy. Assuming earlier provision of ECMO flow, expected survival for eligible arrests will increase by nearly 6% with the rendezvous strategy and approximately 26% with pre-hospital ECPR when compared to the existing in-hospital strategy.

conclusionIn-hospital ECPR provides the least equitable access to ECPR. Rendezvous and pre-hospital ECPR models substantially increased the catchment of eligible OHCA patients. Traffic and spatial modelling may provide a mechanism to design appropriate ECPR service delivery strategies and should be tested through clinical trials.

Indexed as

Cardiopulmonary ResuscitationExtracorporeal Membrane OxygenationOut-of-Hospital Cardiac ArrestHospitalsHumansRetrospective StudiesSurvival RateAccessibilityCardiac arrestEmergency medical servicesExtracorporeal cardiopulmonary resuscitation

Identifiers

PMID36566221
PMCPMC9790130
OpenAlexW4312120258

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.