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Aim: Extracorporeal cardiopulmonary resuscitation (ECPR) is performed in refractory out-of-hospital cardiac arrest (OHCA) patients, and the eligibility has been conventionally determined based on three criteria (initial cardiac rhythm, time to hospital arrival within 45 minutes, and age <75 years) in Japan. Owing to limited information, this study descriptively determined neurological outcomes after applying the three criteria among OHCA patients who underwent ECPR.Methods: This study conducted a post-hoc analysis of data from the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study. This was a multi-institutional prospective observational study of OHCA patients in Osaka Prefecture, Japan. All adult (aged ≥18 years) OHCA patients with internal medical causes treated with ECPR between 1 July 2012 and 31 December 2019 were evaluated. We described one-month neurological favourable outcomes based on the three criteria (initial shockable, time to hospital arrival within 45 minutes, and age <75 years), and we compared them using the chi-square test.Results: Among 18,379 patients screened from the CRITICAL study database, we included 517 OHCA patients treated by ECPR; 311 (60.2%) patients met all three criteria. Favourable neurological outcomes were as follows: patients meeting no or one criterion: 2.3% (1/43), those meeting two criteria: 8% (13/163), and those meeting all criteria: 16.1% (50/311) (P-value = 0.004).Conclusions: In this study, approximately 60% of patients treated by ECPR met the three criteria (initial shockable, time to hospital arrival within 45 minutes, and age <75 years), and the greater the number of criteria met, the better were the neurological outcomes achieved. [ABSTRACT FROM AUTHOR]

Keywords: cardiopulmonary resuscitation; heart arrest EN cardiopulmonary resuscitation heart arrest 1031 1033 3 04/20/20 20200324 NES 200324 Extracorporeal cardiopulmonary resuscitation (ECPR) is expected to benefit the rescue of selected patients, particularly those who are refractory to conventional cardiopulmonary resuscitation (CPR).[1] Considering its invasive procedure and considerable resources, establishing a helpful criterion for initiating ECPR remains crucial. Low-flow duration (LFD) is one of the most common criteria to identify candidates for ECPR.[1] However, the association between LFD and favorable neurological outcome has not been sufficiently investigated in out-of-hospital cardiac arrests (OHCAs). LFD was defined as the time interval from initiation of any CPR (bystander CPR or CPR by emergency medical services personnel) to the initiation of ECPR. [Extracted from the article]