Extracorporeal Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest: A Single-Center Experience in Latin America.

BACKGROUND

Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of extracorporeal membrane oxygenation (ECMO) in patients in whom conventional cardiopulmonary resuscitation measures have failed to achieve a sustained return of spontaneous circulation after cardiorespiratory arrest. Limited information is available in centers in Latin America.

OBJECTIVE

To evaluate in-hospital and long-term clinical outcomes of adult patients treated with ECPR after in-hospital cardiac arrest (IHCA) in a high-complexity center in Argentina.

METHODS

A single-center cohort study was performed. Consecutive adult patients who underwent ECPR between 2014 and 2023 were retrospectively analyzed. Witnessed IHCA cases of probable cardiac origin were included.

RESULTS

Fifteen patients were included in the analysis, representing 16% of the venoarterial ECMO cases implanted at the center during this period. The median age was 46 years (interquartile range [IQR]: 34 to 57); 33% were female. Cannulation was peripheral in 93.3%, and 66% of ECMO runs were placed with an initial bridging strategy to recovery. The median duration of circulatory support was 5 days (IQR: 2 to 9). Venoarterial ECMO was successfully removed in 60% of patients, and in-hospital survival was 46%. Median follow-up after discharge was 12 months (IQR: 3 to 34), with 100% long-term survival.

CONCLUSION

Venoarterial ECMO as a treatment for IHCA in our center demonstrated acceptable survival to hospital discharge and long-term survival. Venoarterial ECMO may be an effective treatment in highly selected patients when conventional therapies fail and may be useful and applicable in a low- and middle-income country with limited access to other circulatory assist devices.