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African Journal of Emergency Medicine

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Study: Extracorporeal cardiopulmonary resuscitation (eCPR) is a rescue therapy for selected patients when conventional cardiopulmo nary resuscitation (CPR) fails. Current evidence suggests that the success of eCPR depends on well-structured in- and out-of-hospital protocols. This article describes the Vienna eCPR program, and the interventions implemented to improve clinical processes and patient outcomes. Methods: In this retrospective study, we report on all patients with in hospital and out-of-hospital cardiac arrest treated with eCPR at our department between 2020 and 2023. During this period, the program was restructured, including the introduction of out-of-hospital and inhospital algorithms and interprofessional training. The primary endpoint was survival with favorable neurologic outcomes at 6 months, defined as a cerebral performance category score of 1 or 2. Results: Overall, 192 patients were treated with eCPR. The pro portion of patients with favorable neurologic outcomes was 25 % (n = 48), increasing each year: 15 % (5/34) in 2020, 19 % (8/42) in 2021, 23 % (12/53) in 2022, and 37 % (23/63) in 2023. This was particularly true for out-of-hospital cardiac arrest patients: 7 % (2/29), 14 % (4/29), 17 % (7/41), and 32 % (16/50), respectively. Simultaneously, rates of wit nessed arrest, bystander CPR, and initial shockable rhythm increased, whereas low-flow durations decreased. Conclusion: After restructuring the Vienna eCPR program, we were able to improve survival rates with favorable neurologic outcomes after eCPR. This improvement was accompanied with increased case vol umes, rates of witnessed arrest, bystander CPR, and initial shockable

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