State-of-the-Art Update in Extracorporeal Cardiopulmonary Resuscitation for Out-of-hospital Cardiac Arrest

Survival of refractory non-traumatic out-of-hospital cardiac arrest (OHCA) remains low despite many advances in care. Extracorporeal cardiopulmonary resuscitation (ECPR) has demonstrated the ability to significantly improve outcomes in select patients suffering refractory OHCA. These trials highlight different, but important, aspects of ECPR and provide insights into how we should design future ECPR systems of care. As the use of ECPR increases, this article updates the state-of-the-art in ECPR for refractory OHCA, highlighting the critical components of contemporary ECPR systems of care, clinical controversies in post-resuscitation strategies, and future areas of research needed.