• Martje M Suverein, Jos G Maessen, and van de PollMarcel C GMCGDepartment of Intensive Care, Maastricht University Medical Center, Maastricht, the Netherlands School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands..
• Department of Intensive Care, Maastricht University Medical Center.
• Curr Opin Crit Care. 2023 Dec 1; 29 (6): 633639633-639.

Purpose Of ReviewExtracorporeal cardiopulmonary resuscitation (ECPR) is an emerging treatment for refractory cardiac arrest. In recent years, several randomized controlled trials have been published that aimed to address the efficacy and effectiveness of ECPR for out-of-hospital cardiac arrest (OHCA). Despite the lack of high-quality evidence concerning clinical effectiveness and cost-effectiveness, ECPR is increasingly implemented throughout the world. In this review, we aim to provide an overview of the current status of ECPR for OHCA.Recent FindingsRandomized controlled trials showed diverging results, largely due to differences in selection criteria and study design. Single-center studies, performed in centers with extraordinary expertise and dedication consistently achieve a low-flow time of around 60 min, but such achievements are rarely reproduced outside these centers. Strict patient selection can improve outcome but simultaneously limits the caseload. Preliminary data suggest that outcome may also be improved by avoiding hyperoxia postresuscitation.SummaryThe potential of ECPR to increase survival in selected patients in highly dedicated systems seems to be proven, the question remains whether ECPR for OHCA can be widely implemented successfully and can develop into a sustainable, commonplace resource-effective treatment.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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