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Observational Study
. 2025 Oct;49(10):1571-1578.
doi: 10.1111/aor.15028. Epub 2025 May 30.

Outcomes of Extracorporeal Cardiopulmonary Resuscitation for Refractory In-Hospital Cardiac Arrest

Thays Sokolov  1 , Thomas Varin  1 , Maxime Zimmermann  1 , Xavier Armoiry  2 , Bertrand Scheppler  3 , Matthias Jacquet-Lagrèze  4   5   6 , Philippe Portran  4 , Anais Schwab  4 , Jean Luc Fellahi  4   5   6 , Martin Ruste  4   5   6 , Matteo Pozzi  1   7
Affiliations
Observational Study

Outcomes of Extracorporeal Cardiopulmonary Resuscitation for Refractory In-Hospital Cardiac Arrest

Thays Sokolov et al. Artif Organs. 2025 Oct.

Abstract

Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is a potential intervention for refractory in-hospital cardiac arrest (IHCA). This study aimed to evaluate the outcomes of ECPR in patients with refractory IHCA at a university-affiliated tertiary care center.

Methods: We performed a retrospective, observational analysis of an institutional database of adult patients who received ECPR for refractory IHCA from January 2007 to December 2023. The primary endpoint was survival to hospital discharge with a favorable neurological outcome, defined as a Cerebral Performance Category (CPC) score of 1 or 2. Patients with a CPC score of 1-2 were compared to those with a CPC score ≥ 3.

Results: During the study period, 147 patients received ECPR for refractory IHCA (mean age 51.0 years, 64.6% male). Baseline characteristics were comparable between both groups. Mean no-flow time and low-flow time and the rate of shockable rhythms were comparable between both groups. Eighty-nine (60.5%) patients died during temporary mechanical circulatory support. Among the 56 (38.1%) patients who were weaned from mechanical circulatory support, 24 (16.3%) died before hospital discharge. The overall survival to discharge was 22.4%, with 20.4% achieving a CPC score of 1-2.

Conclusions: Owing to the invariably fatal nature of refractory IHCA, ECPR offered a reasonable survival with a favorable neurological outcome in this critically ill patients' population.

Keywords: extracorporeal membrane oxygenation; in‐hospital cardiac arrest; neurological outcome.

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References

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