Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest

This multicenter randomized controlled trial (INCEPTION), conducted in the Netherlands, assessed whether extracorporeal CPR (ECPR) improved neurologic outcomes at 30 days compared to conventional CPR in patients aged 18–70 with refractory out-of-hospital cardiac arrest from ventricular arrhythmia. Among 134 patients analyzed (70 ECPR, 64 conventional CPR), 20% in the ECPR group versus 16% in the conventional group survived with favorable neurologic outcomes (CPC 1–2), showing no statistically significant difference (OR 1.4; 95% CI 0.5–3.5; P=0.52). Complication rates and mortality were similar between groups. The trial underscores the logistical complexity and uncertain benefit of ECPR in broader implementation settings and suggests future research should refine indications and site readiness criteria.

This multicenter randomized controlled trial (INCEPTION), conducted in the Netherlands, assessed whether extracorporeal CPR (ECPR) improved neurologic outcomes at 30 days compared to conventional CPR in patients aged 18–70 with refractory out-of-hospital cardiac arrest from ventricular arrhythmia. Among 134 patients analyzed (70 ECPR, 64 conventional CPR), 20% in the ECPR group versus 16% in the conventional group survived with favorable neurologic outcomes (CPC 1–2), showing no statistically significant difference (OR 1.4; 95% CI 0.5–3.5; P=0.52). Complication rates and mortality were similar between groups. The trial underscores the logistical complexity and uncertain benefit of ECPR in broader implementation settings and suggests future research should refine indications and site readiness criteria.