Background: Survival for cardiac arrest remains poor, and the use of extracorporeal cardiopulmonary resuscitation (ECPR) has been suggested as a potential therapy to improve outcomes. Harefield Hospital has been performing ECPR for over a decade; however outcomes have been historically poor.
Methods: A retrospective analysis was performed of all ECPR cases at Harefield Hospital between April 2018 and April 2023. A new structured system including a systematic screening process, strict exclusion criteria, assessment of resuscitation adequacy through physiological stop criteria, drilled and standardised cannulation process, post-resuscitation care and neuroprognostication was rolled out on 1 April 2023. A comparison of ECPR performed pre and post was undertaken.
Results: With the institution of the new system, 13 patients were treated with ECPR over 1 year; of which nine (69.2%) survived with good neurological outcomes at 6 months. In the preceding 3 years, there had been 22 cases; of which, two survived (9.1%). This was a statistically significant higher survival with HR of 4.56 (CI 2.1, 10.2, p<0.05).The average length of hospital stay in the new system was 61.3 days; of which, 32.4 days were in the intensive care unit.
Conclusions: This study shows that it is possible to significantly improve outcomes in ECPR in a single centre by introducing into standard practice, a high-quality bundle of care.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804202 | PMC |
| http://dx.doi.org/10.1136/bmjoq-2024-002934 | DOI Listing |
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