- It remains unclear whether extracorporeal CPR (ECPR) is associated with better outcomes vs CPR for out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA).
Why this matters
- ECPR is recognized as an option for some cardiac arrest (CA) patients by the American Heart Association and European Resuscitation Council.
- However, optimal candidates and therapeutic benefits, if any, are unclear.
- Meta-analysis was not feasible because of heterogeneity.
- There was critical bias risk, especially from confounding, in all studies.
- Quality of evidence deemed very low.
- Adults: forest plots favored ECPR for long-term survival and favorable neurological outcomes.
- Adults: forest plots favored ECPR for survival to discharge, long-term survival, and favorable neurological outcomes;
- Children: forest plots generally favored ECPR for survival to discharge;
- Children: 1 study favored ECPR for favorable neurological outcome.
- Systematic review of 25 observational studies comparing ECPR with CPR in adults and children who experienced CA.
- Results to inform International Liaison Committee on Resuscitation recommendations.
- Outcomes included survival and favorable neurological outcome.
- Funding: None disclosed.
- No randomized controlled trials found.
- No studies of pediatric OHCA.
- Many studies did not adjust results for confounders.