ARREST Trial: ECMO-facilitated Resuscitation in Refractory Cardiac Arrest

arrest trial ecmo cardiac arrest

2020 ARREST 2020 TRIAL M Advanced reperfusion strategies for patients with out-of hospital cardiac arrest (OHCA) and refractory ventricular fibrillation (VF) Phase 2, single center, open-label, randomized clinical trial Objective: To compare implementation of early ECMO facilitated resuscitation compared to standard ACLS resuscitation in adults suffering out of hospital cardiac arrest (OHCA) presenting with an initial rhythm of ventricular fibrillation (VF) or ventricular tachycardia (VT) 30 patients Patients 18 to 75 years of age with initial rhythm of VF or pulseless VT; no return of spontaneous circulation (ROSC) after 3 shocks; body habitus able to support mechanical CPR; estimated transport time < 30 minutes ACLS group (n=15) ECMO-facilitated group (n=15) PRIMARY OUTCOME Survival to hospital discharge % Diff. 36.2;95% CI 3.7 to 59.2, NNT 3 (1.5 – 13.6) Posterior probability of ECMO superiority 0.9861 SECONDARY OUTCOME Cumulative survival HR 0-16, 95% CI 0.06 to 0-41;P<0.0001 Total adverse events 166 Conclusion: Early ECMO-facilitated resuscitation for patients with OHCA and refractory ventricular fibrillation significantly improved survival to hospital discharge compared with standard ACLS treatment. D Yannopoulos et al. The Lancet 2020