Extracorporeal Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest: A Single-Center Experience in Latin America

Abstract Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of extracorporeal membrane oxygenation (ECMO) in patients in whom conventional cardiopulmonary resuscitation measures have failed to achieve a sustained return of spontaneous circulation after cardiorespiratory arrest. Limited information is available in centers in Latin America. Objective: To evaluate in-hospital and long-term clinical outcomes of adult patients treated with ECPR after in-hospital cardiac arrest (IHCA) in a high-complexity center in Argentina. Methods: A single-center cohort study was performed. Consecutive adult patients who underwent ECPR between 2014 and 2023 were retrospectively analyzed. Witnessed IHCA cases of probable cardiac origin were included. Results: Fifteen patients were included in the analysis, representing 16% of the venoarterial ECMO cases implanted at the center during this period. The median age was 46 years (interquartile range [IQR]: 34 to 57); 33% were female. Cannulation was peripheral in 93.3%, and 66% of ECMO runs were placed with an initial bridging strategy to recovery. The median duration of circulatory support was 5 days (IQR: 2 to 9). Venoarterial ECMO was successfully removed in 60% of patients, and in-hospital survival was 46%. Median follow-up after discharge was 12 months (IQR: 3 to 34), with 100% long-term survival. Conclusion: Venoarterial ECMO as a treatment for IHCA in our center demonstrated acceptable survival to hospital discharge and long-term survival. Venoarterial ECMO may be an effective treatment in highly selected patients when conventional therapies fail and may be useful and applicable in a low- and middle-income country with limited access to other circulatory assist devices.