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Updated: Jul 2, 2026

Pediatric Animal Model of Extracorporeal Cardiopulmonary Resuscitation After Prolonged Circulatory Arrest
04:55

Pediatric Animal Model of Extracorporeal Cardiopulmonary Resuscitation After Prolonged Circulatory Arrest

Published on: May 26, 2023

Extracorporeal cardiopulmonary resuscitation for in-hospital cardiac arrest: a comparative cohort study from the

Daniel Joelsons1, Bruno de Arruda Bravim1, Gustavo Saliba1

  • 1Einstein Hospital Israelita, São Paulo, Brazil.

Resuscitation Plus
|July 1, 2026
PubMed

Insights

Extracorporeal cardiopulmonary resuscitation (ECPR) significantly improved survival for in-hospital cardiac arrest (IHCA) patients in Brazil. This study highlights ECPR

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Emergency Medicine

Background:

  • Extracorporeal cardiopulmonary resuscitation (ECPR) is a vital rescue therapy for refractory in-hospital cardiac arrest (IHCA).
  • Limited Brazilian data exist on ECPR effectiveness compared to conventional CPR (cCPR).
  • This study introduces the first Brazilian center with a protocolized ECPR program.

Purpose of the Study:

  • To compare the effectiveness of ECPR versus cCPR in patients with refractory IHCA in Brazil.
  • To evaluate hospital survival and neurological outcomes in ECPR and cCPR groups.
  • To assess the feasibility of implementing a structured ECPR program in Brazil.

Main Methods:

  • Retrospective single-center cohort study at Einstein Hospital Israelita, São Paulo.
  • Included adults (18-75 years) with witnessed, refractory IHCA meeting ECPR eligibility criteria.
  • Compared a cCPR cohort (2017-2025) with an ECPR cohort (2020-2025), analyzing hospital survival and neurological outcomes (CPC ≤ 2).

Main Results:

  • Hospital survival was significantly higher in the ECPR group (43.7%) compared to cCPR (13.6%) (p=0.04).
  • ECPR demonstrated an absolute risk reduction of 30.1% and a number needed to treat of 4.
  • All ECPR survivors achieved favorable neurological outcomes (CPC ≤ 2), with estimated 30-day survival at 50.0% versus 12.1% for cCPR (p=0.02).

Conclusions:

  • ECPR treatment for refractory IHCA in Brazil resulted in improved hospital survival and uniformly favorable neurological recovery.
  • These findings support the feasibility and potential benefits of establishing structured ECPR programs in Brazil.
  • The study provides hypothesis-generating data for future prospective research on ECPR in the Brazilian context.
Abstract

Keywords:
BrazilCardiopulmonary resuscitationExtracorporeal cardiopulmonary resuscitationExtracorporeal membrane oxygenationIn-hospital cardiac arrestSurvival

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