The impact of COVID-19 on extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA): A single centre study

ABSTRACT

Objectives: The COVID-19 pandemic has been affecting everything including ECMO service. At the moment we have to equip PPE before ECPR and we thought it may influence on time to establish venoarterial ECMO and patient outcomes. Method(s) We compared OHCA-patients who underwent ECPR in our hospital before (January 2015 - March 2020) and after (April 2020 - December 2022) the Government of Japan declared a state of emergency in relation to COVID-19. Result(s) There were 32 and 9 patients in the pre- and post-COVID-19 pandemic sample. Of these, 9 (28.1%) vs. 5 (55.6%) survived extracorporeal life support (ECLS), p=0.23, and 4 (12.5%) vs. 2 (22.2%) had good neurologic outcomes (cerebral performance category 1- 2) after ECLS. Seven (21.9%) vs. 1 (12.5%) were discharged or transferred alive from the hospital (one patient of the post-COVID-19 cohort has been still hospitalised for rehabilitation), p>0.99. Mean values of low-flow time were respectively 67.3 minutes (SD 18.3) and 55.6 minutes (SD 17.1), p=0.091, and median values of time to establish ECMO from admission were respectively 32.5 minutes (IQR 15.8) and 26.0 minutes (IQR 4.0), p=0.23. Conclusion(s) There were no differences in time-toECMO or outcomes in patients who underwent ECPR for refractory OHCA before and after the COVID-19 pandemic.