Cardiac arrest & resuscitation
Impact of cardiac rhythm dynamics during cardiopulmonary resuscitation on clinical outcomes in patients treated with extracorporeal cardiopulmonary resuscitation (ECPR): a systematic review and meta-analysis
Authors' conclusion
Rhythm dynamics provide valuable prognostic insights for candidates for extracorporeal cardiopulmonary resuscitation. Rhythm decay toward asystole may predict resuscitation failure and poor neurological survival, suggesting that it should prompt a critical re-evaluation of the appropriateness of extracorporeal cardiopulmonary resuscitation.
Study context
- Population
- Subjects with out-of-hospital cardiac arrest treated with extracorporeal cardiopulmonary resuscitationsubjects in ten observational studies
- Participants
- 5,183 subjects
- Comparison
- Rhythm improvement vs refractory non-shockable rhythms; rhythm decay vs a sustained shockable rhythm
- Outcome
- Survival with a favorable neurological outcome
- Follow-up
- At the longest
Methodological detailsrandom-effects model with the Hartung-Knapp adjustment, ten observational studies
- Random-effects model with the Hartung-Knapp adjustment
- Ten observational studies
Pooled result
As reported in the abstract
RR for favorable neurological outcome (95% CI)
Rhythm Improvement vs refractory non-shockable rhythmsGRADE: Low
3.12(1.26–7.74)
Rhythm Decay vs sustained shockable rhythmGRADE: Moderate
0.41(0.21–0.80)
Further pooled results
Good neurological recovery, by type of rhythm decay (subgroup)
| RR for good neurological recovery (95% CI) | ||
|---|---|---|
| Good neurological recovery, by type of rhythm decay — decay toward asystoleGRADE: Moderate; comparator not stated in the sentence | 0.20 (0.09–0.45) | |
| Decay toward pulseless electrical activity | 0.62 (0.31–1.25) | |
| 0.050.21520RR for good neurological recovery (log scale) |
- Good neurological recovery, by type of rhythm decay (subgroup): GRADE: Low; did not reach statistical significance; comparator not stated in the sentence
Original publication
Impact of cardiac rhythm dynamics during cardiopulmonary resuscitation on clinical outcomes in patients treated with extracorporeal cardiopulmonary resuscitation (ECPR): a systematic review and meta-analysis. Resuscitation. Published 6 October 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →