• Michael Iwashita, Steve Waqanivavalagi, Tobias Merz, and Peter Jones.
• School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
• Emerg Med Australas. 2020 Dec 1; 32 (6): 960-966.

ObjectiveExtracorporeal cardiopulmonary resuscitation (ECPR) is a promising adjunct to routine advanced cardiac life support. Growing worldwide interest in ECPR-use has seen more tertiary centres offering ECPR programmes. New Zealand's nationwide extracorporeal membranous oxygenation service is provided at Auckland City Hospital (ACH). Despite the potential benefits of ECPR, it is currently only offered on an ad hoc basis. It remains unknown whether ACH would manage sufficient numbers of patients to warrant an ECPR programme.MethodsA 12-month retrospective cohort study of the medical records of patients who were managed for cardiac arrest in the resuscitation room of the ED was conducted. Patient characteristics and clinical outcomes were analysed descriptively and audited against a unique set of criteria for a hypothetical ECPR programme.ResultsBetween 1 July 2018 and 30 June 2019, 286 patients died or had a cardiac arrest for which they were managed at ACH. Sixty-five of these patients had an in-hospital cardiac arrest in the ED. Seven (10.8%) of these patients were deemed eligible for hypothetical ECPR. Only one of these seven patients survived to hospital discharge with full neurological recovery.ConclusionsAn ECPR programme at ACH using standardised and agreed criteria may benefit a small number of patients and improve rates of survival to hospital discharge with preservation of neurological function. An ECPR guideline would help clarify for referring services cases that are appropriate for extracorporeal membranous oxygenation consideration, rather than discussing on an ad hoc basis.© 2020 Australasian College for Emergency Medicine.

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