Rapid Prehospital ACcess to ECPR in Prague

Prehospital Extracorporeal Cardiopulmonary Resuscitation: A Pilot Study in Prague

A prospective pilot feasibility study of prehospital ECPR in patients with refractory OHCA

The aim of this pilot prospective study is to assess the feasibility and effectiveness of a prehospital extracorporeal cardiopulmonary resuscitation (ECPR) system for refractory out-of-hospital cardiac arrest (OHCA) in Prague, compared to a historical cohort of in-hospital ECPR recipients from the Prague OHCA trial.

Inclusion Criteria:

• Estimated age 18-70 years
• Refractory out-of-hospital cardiac arrest (3 unsuccessful defibrillations and/or at least 10 minutes of resuscitation in case of pulseless electrical activity)
• Witnessed cardiac arrest
• ECPR team available
• ECPR team alert within 20 minutes from the emergency call

Exclusion Criteria:

• Unwitnessed cardiac arrest
• Asystole
• ETCO2 less than 10 mmHg upon ECPR team arrival
• Known limitations of intensive care (Do Not Resuscitate - DNR status)
• Known severe neurological impairment prior to cardiac arrest (mRS 4-6)
• Suspected or known pregnancy