Establishing a new ECPR referral center in Poland - first year periprocedural results and patient outcomes.

BACKGROUND

Extracorporeal cardiopulmonary resuscitation (ECPR) is predominantly performed in high-volume centres with extensive experience, which may limit its adoption by new facilities. However, data from the Extracorporeal Life Support Organization registry indicate that ECPR is often performed in small-volume centres, suggesting potential for its successful implementation. The aim of the study was to assess the first-year periprocedural results and patient outcomes after launching an ECPR programme in a newly established referral centre.

METHODS

Data from 22 consecutive patients (median age 44.5 years, 77.3% male) who underwent ECPR for out-of-hospital cardiac arrest between May 2023 and May 2024 were retrospectively analysed. The most frequent aetiologies were acute myocardial infarction (31.8%) and pulmonary embolism (22.7%). Periprocedural characteristics, complications, and survival and neurological outcomes at 3 months were assessed.

RESULTS

The median cannulation time was 15.5 minutes (IQR: 15.0-20.0) and median time from cardiac arrest to extracorporeal membrane oxygenation flow was 59.5 minutes (IQR: 40.0-78.8). At 3-month follow-up, the survival rate reached 31.8% (7 patients), and a favourable neurological outcome (a score of 1 or 2 on the Cerebral Performance Category Scale) occurred in 27.3% of the study group (6 patients). The cannulation success rate was 100%. In one case, cannulation was complicated by a perforation of the right femoral artery, necessitating endovascular repair.

CONCLUSIONS

The preliminary results from the first year of our ECPR programme indicate that initiation of such an advanced resuscitative strategy in a newly established centre is achievable, with acceptable short-term clinical and neurological outcomes.