• K H Benjamin Leung, Louise Hartley, Lyle Moncur, Stuart Gillon, Steven Short, ChanTimothy C YTCYDepartment of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada., and Gareth R Clegg.
• Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada; Scottish Ambulance Service, Edinburgh, Scotland. Electronic address: benkh.leung@mail.utoronto.ca.
• Resuscitation. 2024 Jul 1; 200: 110256110256.

BackgroundExtracorporeal cardiopulmonary resuscitation (ECPR) can improve survival for refractory out-of-hospital cardiac arrest (OHCA). We sought to assess the feasibility of a proposed ECPR programme in Scotland, considering both in-hospital and pre-hospital implementation scenarios.MethodsWe included treated OHCAs in Scotland aged 16-70 between August 2018 and March 2022. We defined those clinically eligible for ECPR as patients where the initial rhythm was ventricular fibrillation, ventricular tachycardia, or pulseless electrical activity, and where pre-hospital return of spontaneous circulation was not achieved. We computed the call-to-ECPR access time interval as the amount of time from emergency medical service (EMS) call reception to either arrival at an ECPR-ready hospital or arrival of a pre-hospital ECPR crew. We determined the number of patients that had access to ECPR within 45 min, and estimated the number of additional survivors as a result.ResultsA total of 6,639 OHCAs were included in the geospatial modelling, 1,406 of which were eligible for ECPR. Depending on the implementation scenario, 52.9-112.6 (13.8-29.4%) OHCAs per year had a call-to-ECPR access time within 45 min, with pre-hospital implementation scenarios having greater and earlier access to ECPR for OHCA patients. We further estimated that an ECPR programme in Scotland would yield 11.8-28.2 additional survivors per year, with the pre-hospital implementation scenarios yielding higher numbers.ConclusionAn ECPR programme for OHCA in Scotland could provide access to ECPR to a modest number of eligible OHCA patients, with pre-hospital ECPR implementation scenarios yielding higher access to ECPR and higher numbers of additional survivors.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

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