Cardiac arrest & resuscitation
Extracorporeal cardiopulmonary resuscitation (ECPR) eligible refractory out of hospital cardiac arrests – A post-hoc analysis of the EVIDENCE randomised controlled trial and Registry
Authors' conclusion
Only a small percentage of OHCA patients were considered eligible for ECPR, predominantly due to challenges in accessing ECPR therapy. ECPR-eligible patients, not treated with ECPR, have very poor survival outcomes.
Study context
- Population
- Refractory out-of-hospital cardiac arrest (OHCA) patients in the EVIDENCE randomised controlled trial (RCT) and contemporaneous EVIDENCE RegistryRCT and Registry combined
- Participants
- 1,497 patients
- Primary endpoint
- ECPR eligibility (meeting ECPR criteria, arriving to an ECPR-capable hospital within 1 h of arrest, no sustained ROSC, within ECPR service hours)
Methodological detailspre-specified, post-hoc analysis, RCT and contemporaneous registry (non-randomised data)
- Pre-specified
- Post-hoc analysis
- RCT and contemporaneous registry (non-randomised data)
Primary result
As reported in the abstract
Truly eligible for hospital-based ECPR
Truly eligible for hospital-based ECPR
38
3%
Further findings
Potential ECPR candidates
- Potential hospital-based ECPR candidates
- 79 (5%)
- Potential pre-hospital ECPR candidates
- 350 (23%)
Reasons for exclusion of potential ECPR patients
- Arrival to hospital >1-h post-arrest, arrival to a non-ECPR-capable centre, and/or arrival outside ECPR-capable hours
Survival to hospital discharge of potential ECPR patients
- Survival to hospital discharge
- 5%
Original publication
ECPR eligible refractory out of hospital cardiac arrests – A post-hoc analysis of the EVIDENCE randomised controlled trial and Registry. Resuscitation. Published 29 January 2026. doi:10.
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