Prehospital ECPR in Moravia Silesia Region - Assessing the Effectiveness, Feasibility and Timing of ECMO for Out-of-Hospital Cardiac Arrest

What this Trial Is About

Researchers are evaluating the use of Extracorporeal Membrane Oxygenation (ECMO), also called ECPR, during cardiopulmonary resuscitation (CPR) for patients who experience out-of-hospital cardiac arrest (OHCA). The study aims to determine if starting ECMO treatment directly at the scene of the cardiac arrest, rather than after hospital arrival, can improve neurological outcomes and survival in the Moravian-Silesian region. This observational study explores the feasibility and effectiveness of this approach compared to standard hospital-based ECMO initiation. The intervention involves connecting suitable OHCA patients to ECMO on site by a specialized ECMO team working alongside emergency medical services. ECMO supports the heart and lungs by pumping blood through an external machine that oxygenates and warms it before returning it to the body. The study focuses on patients with ventricular fibrillation or pulseless electrical activity rhythms who receive bystander CPR and are estimated to be between 18 and 70 years old. The ECMO team is dispatched simultaneously with the ambulance to shorten the time from collapse to ECMO initiation. Participants will be monitored from the time of cardiac arrest through hospital treatment and follow-up periods up to six months. Key measures include the time to ECMO implantation, hospital mortality within three weeks, and neurological outcomes assessed by Cerebral Performance Category (CPC) scores and quality of life tools (SF-36 and EQ-5D) at 30 days and six months. The study also simulates emergency scenarios to validate the logistics and timing of on-scene ECMO application. This research will help establish if early ECMO in the field can improve recovery chances after cardiac arrest.

Prehospital ECPR in Moravia Silesia Region