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The following is a summary of “Does extracorporeal cardiopulmonary resuscitation improve survival with favorable neurological outcome in out-of-hospital cardiac arrest? A systematic review and meta-analysis,” published in the December 2024 issue of Critical Care by Pagura et al.
Extracorporeal cardiopulmonary resuscitation (E-CPR) has been suggested to enhance survival and neurological outcomes in patients with refractory out-of-hospital cardiac arrest (OHCA), but recent randomized controlled trials (RCTs) have shown inconclusive results.
Researchers conducted a retrospective study to examine the impact of E-CPR on neurological outcomes compared to conventional cardiopulmonary resuscitation (C-CPR).
They reviewed articles assessing outcomes in adult patients with OHCA treated with either E-CPR or C-CPR up to April 27, 2023. The primary outcome measured was survival with a favorable neurological outcome at discharge or 30 days, with overall survival.
The results showed that 18 studies were included, with E-CPR leading to better survival with favorable neurological outcomes at discharge or 30 days (14% vs 7%, OR 2.35, 95% CI 1.61–3.43, I2= 80%, P < 0.001, Numbers Needed to Treat (NNT) = 17) compared to C-CPR. This trend was consistent when restricting the analysis to RCTs. An overall survival at discharge or 30 days was also improved with E-CPR (OR = 1.71, 95% CI 1.18–2.46, I2 = 81%, P = 0.004, NNT = 11).
Investigators concluded a positive association between E-CPR and improved survival with favorable neurological outcomes and a modest reduction in overall mortality in patients with refractory OHCA.
Source: sciencedirect.com/science/article/abs/pii/S0883944124003691
