New findings point to the influential role of a regional extracorporeal cardiopulmonary resuscitation (eCPR) program in increasing survival rates for patients with out-of-hospital cardiac arrest (OHCA). Results of the Pilot study presented during a late-breaking clinical science session at Cardiovascular Research Technologies (CRT) 2025 noted that 58 patients (27% out of 256 eligible patients) were cannulated for eCPR with a median time from cardiac arrest to cannulation of 66 minutes (IQR 58-78). Overall, survival to hospital discharge (SHD) was 27%, with 20% achieving a favorable neurologic outcome (Cerebral Performance Category 1-2). Further findings revealed that among patients who underwent eCPR, SHD was 28%, and SHD with favorable neurologic outcome was 21%. “Routing for refractory out-of-hospital cardiac arrest can be achieved in an existing Emergency Medical Services (EMS) system of care,” said David Shavelle, MD, Director at the Long Beach Medical Center in California, who was presenting the findings during Saturday’s Late Breaking Clinical Science Coronary session. “This was associated with higher-than-expected survival rates compared to historic controls,” he added. Subgroup analysis The study’s authors also undertook a subgroup analysis of patients with refractory ventricular fibrillation (n=185), which showed similar outcomes. Here, 26% of patients received eCPR and an SHD rate of 27% was achieved while 21% had favorable neurologic recovery. eCPR, which uses extracorporeal membrane oxygenation (ECMO) to support circulation in patients with refractory OHCA, has shown potential in high-performing systems. However, multicenter trials have struggled to confirm a survival benefit, largely due to challenges in patient selection and timely cannulation. Despite additional challenges such as long transport times, the study authors found survival rates comparable to historical survival rates for witnessed, shockable OHCA in the same EMS system. While observational in nature, these findings suggest the potential for improved survival outcomes. “Additional sites are required to increase access to eCPR in Los Angeles County,” investigators in the study noted. Study methods The prospective observational study included 256 patients treated by six fire-based EMS agencies in Los Angeles County. The median age of this patient population was 59 years (interquartile range 49-65) of which 22% of patients were female. These patients were routed to one of four cardiac arrest receiving centers with eCPR capabilities. The primary endpoint was defined as survival to hospital discharge with a secondary outcome defined as survival to hospital discharge with favorable neurologic outcome (CPC 1 or 2). Image Credit: Bailey G. Salimes Image Caption: David Shavelle, MD, presents his late-breaking clinical science Saturday, March 8, 2025, at Cardiovascular Research Technologies (CRT).