Application Results of an Extracorporeal Therapy Protocol in Cardiorespiratory Arrest: A Historical Cohort Study

Abstract

Background/Objectives: This study sought to evaluate the clinical profile, in-hospital management, prognosis, and survival of patients treated for cardiac arrest using extracorporeal therapy in a third-level Spanish hospital before and after the therapy was protocolised. Methods: This study is a historical single-centre cohort study that was conducted from January 2009 to February 2024. In 2019, an in-hospital extracorporeal reanimation therapy protocol was established in the centre's Coronary Intensive Care Unit. As a result, the cohort was split into two groups: the Pre-Protocol group (between 2009 and December 2018) and the Post-Protocol group (between 2019 and February 2024). Results: A total of 26 patients were recruited, i.e., 10 in the first cohort and 16 in the second, with acute myocardial infarction being the most prevalent cause in both cohorts. A 30% (3) to 43.65% (7) increase in survival was observed between the two cohorts (p = 0.48), with CPC 1-2 neurological functionality exceeding 85% of cases in both cohorts (p = 0.7). The mean time from cardiac arrest to the application of extracorporeal therapy decreased from 104.1 min to 41.87 min (p = 0.09). The longer duration of ECMO (p = 0.03) and the longer hospital stay (p = 0.002) are due to a higher survival. Conclusions: The results show a trend in improvement outcomes. The small cohort size makes it difficult to draw robust conclusions, but we want to highlight the importance of applying a specific protocol based on standardised patient selection criteria and the establishment of extracorporeal reanimation therapy.