cardiac arrest ECMO vs. CPR s/p arrest

[polarbebe]

https://www.nejm.org/doi/full/10.1056/NEJMoa2204511
 

ECMO vs CPR study

Interesting study.  I have heard of some US and European hospital(s) that performs out of the hospital ECMO cannulations.   In this study median time to ECLS flow is 74 minutes… time is brain.  I would imagine the sooner the flow to the brain the less severe the anoxic encephalopathy and probably a benefit. 

 

 

Edited January 28 by polarbebe

[MediMike]

Yannopoulous' group out of MN did a similar (albeit smaller, Phase 2) trial back in 2021. 

DOI: 10.1016/S0140-6736(20)32338-2

Stopped the trial early as outcomes were SO much better.  With that being said the Danish trial was looking at all comers while the MN folks only looked at refractory shockable rhythms. 

For some reason I can't access the full NEJM article, even through my institution.  Was there a table for baseline demographics? I'm curious how many were witnessed, the rates of bystander CPR, % shockable rhytms etc.  While I absolutely love the research that the Swedes and Danes put out, their patient population is so incredibly different than ours, take a look at the TTM2 trial for instance, they had a bystander CPR rate of ~80%! That's insane. Also had ~75% shockable rhythms which is dang near the exact opposite of what we have here (80/20 nonshockable/shockable).  So while their research is spot-on I find it a little challenging to look at my folks and think the same factors apply.