Adult extracorporeal cardiopulmonary resuscitation in the United Kingdom 2012 to 2022: A multicentre observational study
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Akhtar,Waqas
Galiatsou,Eftychia
Pinto,Sofia
Brain,Neil
Garcia,Miguel
Govier,Matthew
Finney,Simon
Patel,Sameer
Pauli,Henning
Raitt,James
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2025
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INTRODUCTION: Survival rates for cardiac arrest remain low. Extracorporeal cardiopulmonary resuscitation (ECPR) may offer a survival advantage in carefully selected patients. There is limited published data on ECPR in the UK and therefore this study aims to describe the last 11â??years provision and outcomes of ECPR in the UK. METHODS: This was a multicentre retrospective cohort study in the UK. Centres offering Extracorporeal membrane oxygenation (ECMO) as a potential support in the UK were identified at the first UK ECPR Summit. All centres were asked to submit data on their veno-arterial (VA) ECMO and ECPR patients between 1st January 2012 and 31st December 2022. RESULTS: Over the 11-year period, 2117 patients received VA-ECMO in the UK with 963 survivors at 6â??months (45.5%). Of these there were 302 ECPR runs with 92 survivors (30.5%). ECPR contributed to 14.3% of the total VA ECMO runs, with wide between-centre variation ranging from 5.4% to 73.3%. Centres provided a detailed dataset for 129 of the 172 consecutive ECPR cases for a 5-year period to 31st December 2022. The mean (SD) age was 46â??±â??5â??years, 77% were male and 48.9% presented with a shockable rhythm. The leading cause of cardiac arrest was ischaemic heart disease (45%). Only 14% achieved transient or sustained return of spontaneous circulation prior to initiation of ECMO flow, with mean time CPR to full ECMO flow of 52.5â??±â??17.1â??min. Percutaneous cannulation was performed in 85.3% of cases, with 51.9% of these procedures taking place in the cardiac catheter laboratory. CONCLUSION: In an UK cohort of VA ECMO and ECPR patients, the survival rates were comparable to other international registries. The variation in practice highlights the need to explore and address inequity of access to ECMO and ECPR services.
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Journal of the Intensive Care Society