Rapid Prehospital ACcess to ECPR in Prague

Inclusion Criteria: * Estimated age 18-70 years * Refractory out-of-hospital cardiac arrest (3 unsuccessful defibrillations and/or at least 10 minutes of resuscitation in case of pulseless electrical activity) * Witnessed cardiac arrest * ECPR team available * ECPR team alert within 20 minutes from the emergency call Exclusion Criteria: * Unwitnessed cardiac arrest * Asystole * ETCO2 less than 10 mmHg upon ECPR team arrival * Known limitations of intensive care (Do Not Resuscitate - DNR status) * Known severe neurological impairment prior to cardiac arrest (mRS 4-6) * Suspected or known pregnancy