Researchers are reporting that recipients of extracorporeal cardiopulmonary resuscitation (ECPR)—an alternative to conventional CPR that some emergency rooms are using to save lives—are more likely to be younger, healthier, white, and male. The study is among the first to characterize the ECPR treatment population in the United States, they say. ECPR involves withdrawing blood from a patient using a mechanical pump and returning it into the patient fully oxygenated and under pressure.
In the study, the researchers performed an observational analysis of adult inpatient cardiac arrests nationwide from 2000 to 2018 as reported to the American Heart Association's Get With The Guidelines—Resuscitation registry and restricted to hospitals that provided ECPR. They identified 129,736 patients who had a cardiac arrest —128 654 treated by conventional cardiopulmonary resuscitation and 1082 treated by ECPR—in 224 hospitals that offered ECPR during this period.
Patients were more likely to receive ECPR if they were white, male, younger than 40 years of age, and had no pre-existing health problems. African-Americans and women were significantly less likely to receive ECPR, they said. Hospitals offering ECPR were larger metropolitan teaching hospitals and had higher cardiac and overall volumes, the researchers noted.
ECPR, whose use has increased over the past 20 years, is currently used in less than 1% of all US in‐hospital cardiac arrests. Randomized controlled trials are needed to better define the patients in whom ECPR may provide a benefit, the researchers said. They published their study, funded in part by the NHLBI, in the Journal of the American Heart Association.