Patient characteristics and prehospital data in patients with refractory cardiac arrest evaluated for possible ECPR treatment stratified according to whether treatment was initiated or not
| Variable | Total (n=579) | ECPR initiated (n=221) | No ECPR (n=358) | P value |
| Age (years) | 58 (49–67) | 54 (46–61) | 62 (53–70) | <0.001 |
| Male sex | 463 (78) | 186 (84) | 277 (78) | 0.08 |
| BMI (kg/m2) | 27 (24–31) | 27 (24–30) | 28 (24–31) | 0.76 |
| Comorbidities | ||||
| History of ischaemic heart disease | 99 (17) | 33 (15) | 66 (18) | 0.27 |
| Heart failure reduced ejection fraction | 64 (11) | 17 (8) | 47 (13) | 0.09 |
| Type 2 diabetes | 61 (11) | 20 (9) | 41 (12) | 0.56 |
| Peripheral vascular disease | 22 (4) | 10 (5) | 12 (3) | 0.49 |
| Obstructive pulmonary disease | 26 (5) | 2 (1) | 24 (7) | 0.002 |
| Presumed cause of cardiac arrest, | ||||
| Acute myocardial infarction | 249 (44) | 135 (63) | 114 (33) | <0.001 |
| Pulmonary embolism | 50 (9) | 23 (11) | 27 (8) | 0.16 |
| Primary arrhythmia | 92 (16) | 36 (17) | 56 (16) | 0.58 |
| Aortic dissection | 32 (6) | 5 (2) | 27 (8) | <0.001 |
| Other | 124 (22) | 8 (4) | 116 (33) | <0001 |
| Witnessed arrest | 488 (84) | 191 (86) | 297 (83) | 0.46 |
| Bystander CPR | 530 (92) | 209 (95) | 321 (90) | 0.16 |
| Distance to centre | 0.25 | |||
| <25 km | 172 (30) | 68 (32) | 104 (30) | |
| 25–50 km | 170 (30) | 56 (26) | 114 (32) | |
| 51–100 km | 127 (22) | 56 (26) | 71 (20) | |
| >100 km | 100 (18) | 36 (17) | 64 (18) | |
| Prehospital intubation | 551 (96) | 209 (95) | 342 (96) | 0.85 |
| Signs of life during prehospital CPR | 161 (29) | 90 (42) | 71 (20) | < 0.001 |
| Initial presenting rhythm | <0.001 | |||
| Shockable (VT/VF) | 319 (55) | 151 (68) | 168 (47) | |
| PEA | 149 (26) | 41 (19) | 108 (30) | |
| Asystole | 93 (16) | 20 (9) | 73 (21) | |
| Mechanical compression (LUCAS) | 537 (93) | 204 (93) | 333 (93) | 0.67 |
| ALS-TOR rule* | 7 (1) | 2 (1) | 5 (1) | 0.32 |
| ETCO2 after intubation (kPa) | 3.5 (2.4–4.6) | 3.5 (2.5–4.6) | 3.5 (2.3–4.7) | 0.59 |
| No-flow (min)† | 0 (0–2) | 0 (0–2) | 0 (0–3) | 0.18 |
| Time from arrest to EMS arrival, min | 7 (2–12) | 7 (3–12) | 7 (2.0–11.0) | 0.64 |
| Prehospital low-flow time (min)‡ | 65 (50–83) | 70 (56–85) | 62 (48–81) | 0.005 |
| Total low-flow time (min)§ | 79 (55–104) | 100 (79–120) | 67 (50–84) | <0.001 |
*ALS-TOR denotes rule for termination of advanced life support based on absence of ROSC, shock delivered, witnessed arrest and/or bystander CPR. Values are presented as medians and IQR or numbers and percentages. A value of p<0.05 is considered statistically significant.
†Time from cardiac arrest to bystander CPR.
‡Time from cardiac arrest to arrival at centre.
§Time from cardiac arrest to death or establishment of mechanical circulatory support.
BMI, body mass index; CPR, cardiopulmonary resuscitation; ECPR, extracorporeal cardiopulmonary resuscitation; EMS, emergency medical service; ETCO2, end-tidal carbon dioxide; LUCAS, Lund University Cardiopulmonary Assist System; PEA, pulseless electrical activity; ROSC, return of spontaneous circulation; VF, ventricular fibrillation; VT, ventricular tachycardia.