• Loes Mandigers, Erik Scholten, Wim J R Rietdijk, Corstiaan A den Uil, Robert J van Thiel, Sander Rigter, Bram G A D H Heijnen, Diederik Gommers, and Dinis Dos Reis Miranda.
• Department of Adult Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands. Electronic address: l.mandigers@erasmumc.nl.
• Resuscitation. 2019 Mar 1; 136: 8-13.

BackgroundCardiac arrest (CA) due to pulmonary embolism (PE) is associated with low survival rates and poor neurological outcomes. We examined whether Extracorporeal Cardiopulmonary Resuscitation (ECPR) improves the outcomes of patients who suffer from CA due to massive PE.MethodsWe retrospectively included 39 CA patients with proven or strongly suspected PE in two hospitals in the Netherlands, in a 'before/after'-design. 20 of these patients were treated with Conventional Cardiopulmonary Resuscitation (CCPR) and 19 patients with ECPR.ResultsThe main outcomes of this study were ICU survival and favourable neurological outcome, defined as Cerebral Performance Category (CPC) score 1-2. The ICU survival rate in CCPR patients was 5% compared to 26% in ECPR patients (p<0.01). Survival with favourable neurological outcome was present in 0/20 (0%) CCPR patients compared to 4/19 (21%) of the ECPR patients (p<0.05).ConclusionECPR seems a promising treatment for cardiac arrest patients due to (suspected) massive pulmonary embolism compared to conventional CPR, though outcomes remain poor.Copyright © 2018 Elsevier B.V. All rights reserved.

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