EVENT ABSTRACTS
Background
Survival for cardiac arrest remains poor and the use of extracorporeal cardiopulmonary resuscitation (ECPR) has been suggested as a potential therapy to improve outcomes. Harefield hospital has been performing ECPR for over a decade, however outcomes had been historically poor.
Methods
A retrospective analysis was performed of all ECPR cases at Harefield Hospital between April 2018 and April 2023. A new structured system including a systematic screening process, strict exclusion criteria, assessment of resuscitation adequacy through physiological stop criteria, drilled and standardised cannulation process, post-resuscitation care and neuroprognostication was rolled out on 1st April 2023 and a comparison of ECPR performed pre and post was undertaken.
Results
With the institution of the new system 13 patients were treated with ECPR over one year of which 9 (69.2%) survived with good neurological outcomes at 6 months. In the preceding three years there had been 22 cases of which 2 survived (9.1%). This was a statistically significant higher survival with hazard ratio 4.56 (CI 2.1, 10.2, p <0.05).
The average length of hospital stay in the new system was 61.3 days of which 32.4 days were in the intensive care unit in the new cohort.
Conclusions
This study shows that it is possible to significantly improve outcomes in ECPR in a single centre by introducing into standard practice a high-quality bundle of care
Waqas is the only UK Specialist Registrar in Cardiology & Intensive Care with a particular interest in cardiogenic shock, heart transplantation and mechanical circulatory support. He is chair of the Academy of Medical Royal Colleges Trainee Doctors Committee, national trainee representative on the Board of the Faculty of Intensive Care Medicine, trainee representative in organ donation at NHS Blood & Transplant London, honorary treasurer critical care section council at Royal Society of Medicine and Co-President at British Transplant Physician Trainees.
