Revolutionizing Accelerated Percutaneous Initiation and Deployment of ECPR (RAPID ECPR): Single-Center Process and Outcomes.

OBJECTIVES

Recent randomized controlled trials comparing extracorporeal cardiopulmonary resuscitation (ECPR) with conventional cardiopulmonary resuscitation (CCPR) reveal mixed outcomes; however, current data support an association between ECPR and neurologically intact survival, particularly within a meticulously trained and highly functional extracorporeal membrane oxygenation (ECMO) delivery system. Rapid deployment of ECPR is critical to achieving favorable outcomes. We describe the implementation of a single-center ECPR program at Mayo Clinic, incorporating an ECPR emergency backpack, clinical lead ECMO specialists, and an emergency ECPR checklist to enhance deployment efficiency and outcomes.

DESIGN

Data were extracted from electronic medical records to assess clinical outcomes, including survival to hospital discharge with favorable neurologic status.

SETTING

A tertiary and quaternary care academic medical center.

PARTICIPANTS

Fifty-eight adult patients who underwent ECPR between October 3, 2020, and December 31, 2023.

INTERVENTIONS: Implementation of a structured ECPR program incorporating an emergency ECPR backpack, clinical lead ECMO specialists, and an emergency ECPR checklist to streamline deployment and improve outcomes.

MEASUREMENTS AND MAIN

RESULTS

Of 58 patients treated with ECPR, the overall rate of neurologically intact survival to hospital discharge was 34.5%, including 41.2% for out-of-hospital cardiac arrest and 31.7% for in-hospital cardiac arrest.

CONCLUSIONS

This single-center experience demonstrates the feasibility and impact of a streamlined ECPR program emphasizing rapid deployment, standardized processes, and dedicated personnel. Our model provides a reproducible framework for institutions seeking to enhance ECPR timeliness and neurologically intact survival following cardiac arrest.