LandmarkRCT

INCEPTION

Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest.

The New England journal of medicine, 2023 · Multicenter randomized trial

Population: Refractory witnessed OHCA, selected adults with initial ventricular arrhythmia
Intervention: Early ECPR program
Comparator: Conventional CPR
Primary outcome: 30-day survival with favorable neurologic outcome
Result: 20% versus 16%; OR 1.4 (95% CI 0.5–3.5), P=.52.

What the trial found

20% versus 16%; OR 1.4 (95% CI 0.5–3.5), P=.52.

Clinical interpretation

Program selection, transport and delivery matter; no basis for routine ECPR in all refractory arrests.

Moderate certainty

Clinical Context & Relevant Topics (1)

Disease Reference

ECMO: Physiology, Bedside Management & Troubleshooting

Specialist-level VV/VA ECMO bedside management: selection, cannulation, gas exchange, hemodynamics, anticoagulation, circuit troubleshooting, organ support, ultrasound, ECPR, weaning and decannulation.

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