Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center.

Extracorporeal cardiopulmonary resuscitation (eCPR) is a method for initiation of cardiopulmonary bypass during resuscitation of a patient with refractory cardiac arrest to support end-organ perfusion. This retrospective study evaluates which prognostic markers are seen in patients with poor outcomes who underwent eCPR in our rural tertiary care center. All patients who underwent eCPR at our center from May 2013 to January 2023 were analyzed in a retrospective manner. We then compared outcomes in patients who survived to discharge (survivors) versus those who did not survive to discharge (non-survivors). Demographic factors, body mass index, peak serum lactate in 24 h, initial rhythm, lowest mean arterial pressure within the first six hours, a requirement of renal replacement therapy, and the number of blood transfusions required during the hospitalization were analyzed. 37 patients (24 males and 13 females) with a median age of 58 years (IQR: 48-65) were included. The overall mortality rate was 75.7%, and all survivors had good neurological outcomes, which were defined as Cerebral Performance Category (CPC) scores of 1 or 2. The most significant factors seen in non-survivors were obesity as measured by BMI more than 30 (odds ratio = 7.33; 95% CI 1.40-38.33; = 0.02), and lowest MAP <65 within the first 6 h despite being on extracorporeal membrane oxygenation (0% vs. 74.1%; = <0.01). This retrospective study demonstrates that initial presentations of patients who underwent eCPR with obesity and MAPS < 65 within the first 6 h despite ECMO support were seen in patients with higher mortality.