On-scene extracorporeal pulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) seems to speed up the start of extracorporeal membrane oxygenation (ECMO) and shorten low flow during cardiopulmonary resuscitation (CPR) in case of refractory cardiac arrest. The primary goal is to verify the benefit of on-scene ECPR in terms of shortening the collapse-to-ECMO interval. The secondary goal is to compare outcomes in the on-scene ECPR group with hospital cannulation.
ECPR is a life-saving method for a selected group of patients who are refractory to standard resuscitation procedures. With the appropriate use of ECPR, it is possible to achieve a significant improvement in survival with good neurological outcomes even in patients who would otherwise die. The ECMO Centre Ostrava has been providing ECPR for OHCA since 2022 with cannulation in the hospital after prior transport from the scene under continuous resuscitation. A good neurological outcome is achieved in approximately 29% of patients, even though the collapse-ECMO interval is around 75 minutes. Shortening this interval, which is associated with improved outcomes, is possible by using a mobile team that per-forms cannulation directly on scene. Mobile ECPR will be carried out in cooperation with the Ostrava University Hospital and the Moravian-Silesian Region Emergency Medical Service. The primary objective is to verify the benefit of on-scene ECPR in terms of shortening the collapse-ECMO interval. The secondary objective is to compare the outcome in the on-scene ECPR group with hospital cannulation.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
90
ECPR (Extracorporeal Cardiopulmonary Resuscitation) is a critical, advanced resuscitation technique using Veno-arterial Extracorporeal Membrane Oxygenation for patients in cardiac arrest where conventional CPR fails, functioning as a bridge to restore circulation and oxygenation by pumping and oxygenating blood outside the body before returning it.
ECPR (Extracorporeal Cardiopulmonary Resuscitation) is a critical, advanced resuscitation technique using Veno-arterial Extracorporeal Membrane Oxygenation for patients in cardiac arrest where conventional CPR fails, functioning as a bridge to restore circulation and oxygenation by pumping and oxygenating blood outside the body before returning it.
Emergency Medical Services, Moravian-Silesian Region
Ostrava, Moravian-Silesian Region, Czechia
RECRUITINGUniversity Hospital Ostrava
Ostrava, Moravian-Silesian Region, Czechia
RECRUITINGHospital survival
Hospital survival will be assessed 30 days after the cardiac arrest
Time frame: 30 days after the cardiac arrest
ICU stay
The length of the Intensive Care Unit (ICU) stay will be assessed in days.
Time frame: Through the ICU stay, on average 12 days
Neurologic outcomes
Neurologic outcomes will be assessed in patients using the Cerebral Performance Category (CPC) score. The CPC score is a 1-to-5 scale assessing neurological outcome, most commonly after cardiac arrest, where 1 is best (normal brain function) and 5 is worst (brain death).
Time frame: 30 days after the cardiac arrest
Collapse to ECMO interval
The interval from the collapse (cardiac arrest) to ECMO initiation will be measured in minutes.
Time frame: One hour
Collapse to ECMO interval
The interval from the collapse (cardiac arrest) to ECMO initiation will be measured in minutes.
Time frame: From the collapse (cardiac arrest) to ECMO initiation
Long-term outcome - Survival
The long-term survival of patients will be assessed 6 months after the collapse.
Time frame: 6 months after the collapse
Long-term outcome - Quality of Life
Long-term quality of life will be assessed 6 months after the collapse using standardised tools (questionnaires).
Time frame: 6 months after the collapse
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.