Pre-hospital extracorporeal cardiopulmonary resuscitation (ECPR) for adult patients experiencing refractory out-of-hospital cardiac arrest (OHCA)

What were we asked to look at?

Scottish health technology group (SHTG) has been asked to review evidence on the clinical effectiveness, cost effectiveness and safety of pre-hospital extracorporeal cardiopulmonary resuscitation (ECPR) compared with standard advanced life support (ALS) without ECPR, for adult patients (16–65 years) experiencing refractory out-of-hospital cardiac arrest (OHCA).

Why is this important?

Out-of-hospital cardiac arrest (OHCA) is a major health burden and national priority for Scotland. Of the 3800 patients who have resuscitation attempted in the community each year fewer than 10% of patients survive with good neurological outcomes, and for refractory cases, recovery rates are below 1%.

Currently advanced life support techniques provide only partial circulatory restoration and cannot prevent severe brain injury during prolonged resuscitation. As an emerging innovation in advanced resuscitation, ECPR offers the potential to transform these outcomes, increasing survival with good neurological recovery and reducing long-term disability.

Our work will inform decision making on the potential introduction of pre-hospital ECPR in Scotland.