Acute cardiac care & resuscitation

Extracorporeal cardiopulmonary resuscitation (ECPR) eligible refractory out of hospital cardiac arrests – A post-hoc analysis of the EVIDENCE randomised controlled trial and Registry

ResuscitationPublished pre-specified, post-hoc analysis

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 RegistryOHCA patients in the combined RCT and Registry
Participants
1,497 participants
Comparison
Truly eligible hospital-based ECPR patient vs Potential ECPR patients
  • Truly eligible hospital-based ECPR patientn = Thirty-eight
Methodological detailsrandomised controlled trial (RCT) - EVIDENCE and the contemporaneous EVIDENCE Registry (non-randomised data)
  • Randomised controlled trial (RCT) - EVIDENCE and the contemporaneous EVIDENCE Registry (non-randomised data)

Primary result

As reported in the abstract

Truly eligible for hospital-based ECPR

Thirty-eight of 1497 OHCA patients

3%

Further findings

Main 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 of ECPR-capable hours

Potential ECPR candidates

Potential hospital-based ECPR candidates: Seventy-nine
5%
Potential pre-hospital ECPR candidates: 350
23%

Survival to hospital discharge of potential ECPR patients

Survival to hospital discharge of potential ECPR patients
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:10.1016/j.resuscitation.2026.110996

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