ReviewResuscitation2025
Development of a health equity tool in resuscitation sciences and application to current research in extracorporeal cardiopulmonary resuscitation for cardiac arrest.
Review in Resuscitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled 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.
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
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Using serious games for cardiopulmonary resuscitation training: a meta-analysis and systematic review.Frontiers in public health · 2026Pooled it
- Part 3: Ethics: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation · 2025Guideline
- Resuscitation needs justice: an intersectional view on justice, equity, diversity, and inclusion.Resuscitation plus · 2026Article
- Outcomes and implications of patients included vs excluded for extracorporeal cardiopulmonary resuscitation after initial activation.Resuscitation plus · 2026Article
- Health Equity in Systematic Reviews: A Tutorial-Part 2 Implementing Health Equity Throughout Your Methods.Cochrane evidence synthesis and methods · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundExtracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for adults with cardiac arrest (CA) refractory to Advanced Cardiovascular Life Support (ACLS). Concerns exist that adding ECPR could worsen health inequities, defined as differences in health outcomes that are unfair or unjust. Current guidelines do not explicitly address this issue. This study narratively reviews the latest evidence on ECPR, focusing on its implications for health equity and derives a health equity tool that may serve as a basis of comparison for resuscitation sciences.
methodsWe searched the American Heart Association (AHA) and International Liaison Committee on Resuscitation (ILCOR) websites for the latest ACLS guidelines and scientific summaries on ECPR for CA and identified randomized controlled trials (RCTs) and observational studies. We identified population and individual characteristics associated with inequities based on the literature and expert opinion. These characteristics were used as a health equity tool to assess: differences in baseline risk, population exclusion and trial representation in studies, outcome analyses, and implementation barriers. We used the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) Evidence to Decision (EtD) framework to evaluate ECPR's impact on health equity.
resultsFour RCTs involving 435 patients were conducted in the (2/4) USA, (1/4) Czech Republic, and (1/4) Netherlands. We identified thirteen characteristics associated with health inequities. All trials took place in urban, high-resourced hospitals and excluded older adults (60-75+ years). Across all RCTs, women were under-represented, and in the two USA-based trials, Black individuals were under-represented. There was no difference in baseline rate of survival with minimal or no neurologic impairment between sexes, but an observed trend favoring younger patients (<65). One trial's subgroup analysis showed no significant differences in ECPR effectiveness by sex or age. We noted that implementing ECPR for out-of-hospital CA faces challenges due to demographic variability, differences in emergency services, access to existing ECPR programs, and limited implementation outside urban areas.
conclusionsA health equity tool based on axes of health inequities for resuscitation identified that health equity is reduced with the use of ECPR for CA. Mitigation strategies should involve evaluating demographics, health equity measures, outcomes and ensuring equitable access to ECPR across catchment areas before and after implementation.
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Registered trials
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.