Establishing a new ECPR referral center in Poland - first year periprocedural results and patient outcomes

Extracorporeal cardiopulmonary resuscitation (ECPR) is predominantly performed in high-volume centres with extensive experience, which may limit its adoption by new facilities. However, data from the Extracorporeal Life Support Organization registry indicate that ECPR is often performed in small-volume centres, suggesting potential for its successful implementation. The aim of the study was to assess the first-year periprocedural results and patient outcomes after launching an ECPR programme in a newly established referral centre.

Data from 22 consecutive patients (median age 44.5 years, 77.3% male) who underwent ECPR for out-of-hospital cardiac arrest between May 2023 and May 2024 were retrospectively analysed. The most frequent aetiologies were acute myocardial infarction (31.8%) and pulmonary embolism (22.7%). Periprocedural characteristics, complications, and survival and neurological outcomes at 3 months were assessed.

The median cannulation time was 15.5 minutes (IQR: 15.0-20.0) and median time from cardiac arrest to extracorporeal membrane oxygenation flow was 59.5 minutes (IQR: 40.0-78.8). At 3-month follow-up, the survival rate reached 31.8% (7 patients), and a favourable neurological outcome (a score of 1 or 2 on the Cerebral Performance Category Scale) occurred in 27.3% of the study group (6 patients). The cannulation success rate was 100%. In one case, cannulation was complicated by a perforation of the right femoral artery, necessitating endovascular repair.

The preliminary results from the first year of our ECPR programme indicate that initiation of such an advanced resuscitative strategy in a newly established centre is achievable, with acceptable short-term clinical and neurological outcomes.