• Kazunori Fukushima, Makoto Aoki, Jun Nakajima, Yuto Aramaki, Yumi Ichikawa, Yuta Isshiki, Yusuke Sawada, and Kiyohiro Oshima.
• Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. Electronic address: m10201076@gunma-u.ac.jp.
• Am J Emerg Med. 2022 Mar 1; 53: 144149144-149.

BackgroundOut-of-hospital cardiac arrest (OHCA) patients who convert from an initial non-shockable rhythm to a subsequent shockable rhythm reportedly have a better prognosis for survival than those without rhythm conversion. We evaluated the effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for OHCA patients with a subsequent shockable rhythm.MethodsThis study was conducted using the Japanese Association of Acute Medicine OHCA registry. We included OHCA patients with a subsequent shockable rhythm from June 2014 to December 2017. The included patients were divided into those with and without ECPR. The primary outcome was 30-day survival. Logistic regression analysis and propensity score matching were performed to compare the outcomes between patients with and without ECPR.ResultsA total of 2,102 patients were analyzed, consisting of 162 with ECPR and 1,940 without ECPR. Before propensity score matching, 24 (14.8%) patients with ECPR and 61 (3.1%) patients without ECPR survived for 30 days; ECPR was associated with increased survival (P < 0.05; odds ratio [OR], 5.35; 95% confidence interval [CI], 3.09-9.02). After propensity score matching, 22/149 (14.8%) patients with ECPR and 10/149 (6.7%) patients without ECPR survived for 30 days; ECPR was associated with increased survival (P < 0.05; OR, 2.40; 95% CI, 1.04-5.91).ConclusionsECPR was associated with increased survival among OHCA patients with a subsequent shockable rhythm.Copyright © 2022 Elsevier Inc. All rights reserved.

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