Early ECMO during CPR increases chances of survival: study

When a patient in cardiac arrest fails to regain breathing and blood circulation despite continued CPR (cardiopulmonary resuscitation), the chances of reviving the patient decrease significantly.

However, a new study has found that if ECMO (extracorporeal membrane oxygenation) is done simultaneously, the patient’s chances of survival increase, and the sooner, the better.

A research team, led by Professors Lee Sang-wook and Sim Ji-hoon of the Department of Anesthesiology and Pain Medicine at Asan Medical Center, said Tuesday that they analyzed 1,950 patients who received CPR at the hospital over the past five years and found that patients who received early ECMO treatment had a better survival prognosis.

The hospital said the study is significant because it highlights the importance of early ECMO during CPR.

The researchers analyzed data from 1,950 patients who received CPR at Asan Medical Center from March 2019 to April 2023. Of these, 198 patients were treated with ECMO during CPR. According to the time of ECMO administration, they were categorized into three groups: within 20 minutes, 20-40 minutes, and over 40 minutes.

When the correlation between the time from CPR to ECMO and mortality was examined, 23.2 percent of patients in the group that received ECMO within 20 minutes died within 30 days. In contrast, the short-term mortality rate within 30 days was 37.4 percent in the group where ECMO was administered after 40 minutes or more.

It suggests that the time between CPR and ECMO intervention is significantly associated with increased mortality.

“These findings confirm that reducing the interval between CPR initiation and ECMO introduction is important to improve the patient's chances of survival,” Professor Lee said. “The use of ECMO during CPR improves circulation in the body of cardiac arrest patients and improves their neurological prognosis.

Professor Shim said, “However, in patients with trauma, drug addiction, suspected severe brain injury, or terminal cancer, ECMO may not improve survival. Except in these cases, ECMO treatment should be introduced early in patients who do not regain spontaneous circulation despite continuous CPR.”

The findings were published in The Journal of Internal Medicine (impact factor 9.0), a prestigious publication in internal medicine.