Abstract:

Objective To analyze the clinical application of Extracorporeal Cardiopulmonary Resuscitation （ECPR） in patients with refractory cardiac arrest in the emergency department and to investigate the factors affecting survival and neurological outcomes. Methods A retrospective analysis was conducted on the clinical data of 61 patients who underwent Extracorporeal Membrane Oxygenation （ECMO） for cardiopulmonary resuscitation at the emergency department from January 2021 to March 2024. The hospital discharge survival rate， favorable neurological outcome rate， and incidence of complications were summarized. Factors affecting survival and neurological outcomes were also analyzed. Results In a study of 61 patients， the ECMO weaning success rate was 55.7%， the hospital discharge survival rate was 29.5%， the favorable neurological prognosis rate was 21.3%， and the incidence of complications was 47.5%. The proportion of initial cardiac rhythm being shockable was significantly higher in the survival group compared to the mortality group. The ECMO establishment time， low-flow time， and pre-ECMO blood lactate levels were all significantly lower in the survival group than in the mortality group. The pre-ECMO blood pH level was higher in the survival group. The ECMO maintenance time and ICU stay were significantly longer in the survival group than in the mortality group， with all P-values being less than 0.05， indicating statistically significant differences. Patients with an initial shockable cardiac rhythm and low-flow time ≤ 60 minutes had a better favorable neurological prognosis rate. Conclusions Extracorporeal cardiopulmonary resuscitation can provide effective life support for patients with refractory cardiac arrest. Patients with an initial shockable rhythm， lower blood lactate levels and higher pH levels before ECMO support， and shorter low-flow time have a better prognosis.

Key words: extracorporeal membrane oxygenation, cardiopulmonary resuscitation, cardiac arrest