[ECMO Treatment for CPR in Shaare Zedek Medical Center - A Seven Year Cohort]

The Extracorporeal Membrane Oxygenation (ECMO) service at the Shaare Zedek Medical Center was established in 2015. In 2017, the first patient underwent emergent ECMO cannulation during extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest .

To describe outcomes of ECPR at Shaare Zedek Medical Center.

A retrospective analysis of all patients who underwent ECPR.

Between the years 2017 and 2024, a total of 108 patients underwent ECPR. Of these, in 62 cases it was due to out-of-hospital cardiac arrest (OHCA), and in 46 cases it was due to in-hospital cardiac arrest (IHCA). The median age was 56 (42-64) years, and 26% of patients were female. The most common diagnosis was acute coronary syndrome. The median duration of ECMO was 3 (1-6) days, and after one week, 75% of patients were either weaned off the device or had died. Of the entire cohort, 24 (22%), in the OHCA cohort 9/62 (15%) and in the IHCA cohort 15/46 (33%) survived, with a statistically significant difference noted between groups (p=0.025). Initial pH values were higher and lactate values lower in survivors vs non-survivors (p=0.015 and p=0.018, respectively).

ECMO-facilitated resuscitations for refractory cardiac arrest at Shaare Zedek Medical Center have steadily increased over time. However, better characterization of patient variables associated with survival in this severe condition is still necessary.