Prehospital Extracorporeal Life Support in Refractory Out-of-Hospital Cardiac Arrest.

Prehospital ECPR via venoarterial extracorporeal membrane oxygenation in HEMS for refractory out-of-hospital cardiac arrest patients ≤50 is linked to 40% survival to discharge.

• Why it matters: Evidence comparing prehospital ECPR with conventional care in young adults with refractory out-of-hospital cardiac arrest is limited, leaving uncertainty about survival and neurologic outcomes.
• What they did: In a nationwide nonrandomized Netherlands study, HEMS-equipped teams delivering prehospital ECPR (n=144) were compared with HEMS without ECPR capability (n=87), using survival to hospital discharge as the primary outcome.
• The result: Survival to hospital discharge was 57/144 (40%) versus 17/87 (20%) (odds ratio 2.72; 95% CI 1.59 to 4.66; P=0.002), and favorable neurologic outcome at 6 months was 36% versus 13%.

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