Suverein MM, et al. N Engl J Med. 2023 Jan 26;388(4):299-309. doi: 10.1056/NEJMoa2204511.
Question and Methods: Does eCPR increase survival at 30 days with good neurologic outcome in refractory OHCA caused by an initial cardiac ventricular arrhythmia when compared to conventional CPR.
Findings: No difference was found in survival in a multicenter, pragmatic, randomized controlled trial of 160 adult patients conducted in the Netherlands (OR 1.4 (95% CI 0.5-3.5), P=0.52, RR 1.05 (95% CI 0.97-1.13) or in adverse events (eCPR n= 1.4 (±0.9) vs, conventional CPR n=1 (±0.6), P=>0.5).
Limitations: Small number of participants and lack of protocol for EMS and hospital staff. A substantial number of patients regained ROSC between randomization and arrival at hospital. Lack of information led to post-randomization exclusion. Impossible to mask providers to treatment group assignments.
Interpretation: The current available data do not yet support the use of eCPR in patients with OHCA.
JC Supervisor: Dr. Ian Stiell
Dr. Graham Wilson is a FRPCP Emergency Medicine resident at the University of Ottawa with a passion for the outdoors, and sustainable environmental change.
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.
MD, MSc, FRCPC