Cardiac arrest & resuscitation
Prevalence, reasons, and timing of decisions to withhold/withdraw life-sustaining therapy for out-of-hospital cardiac arrest patients with extracorporeal cardiopulmonary resuscitation
Authors' conclusion
For approximately one-third of ECPR/OHCA patients, WLST was decided during admission, mainly because of perceived unfavorable neurological prognoses.
Study context
- Population
- Adults who underwent extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) with medical causes, Japan
- Participants
- 1,660 adults
- Comparison
- Withhold/withdraw life-sustaining therapy (WLST) vs no-WLST
- WLSTn = 510
- Primary endpoint
- Prevalence, reasons and timing of WLST decisions
Methodological detailsmulticentre
- Multicentre
Primary result
As reported in the abstract
WLST
30.7%
510
- Perceived unfavorable neurological prognosis
- 300/510 [58.8%]
- Perceived unfavorable cardiac/pulmonary prognosis
- 105/510 [20.5%]
- Inability to maintain extracorporeal cardiopulmonary support
- 71/510 [13.9%]
- Complications
- 10/510 [1.9%]
- Exacerbation of comorbidity before cardiac arrest
- 7/510 [1.3%]
Further findings
30-day survival · 36/506 vs 386/1140
P < 0.001
Factors associated with WLST decisions
- Primary cerebral disorders as cause of arrest and higher severity of illness at ICU admission associated with WLST decisions
Original publication
Prevalence, reasons, and timing of decisions to withhold/withdraw life-sustaining therapy for out-of-hospital cardiac arrest patients with extracorporeal cardiopulmonary resuscitation. Crit Care. Published 27 June 2023. doi:10.
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