Background

Extracorporeal cardiopulmonary resuscitation (eCPR) is a new approach for cardiac arrest management and is regarded as a possible alternative for conventional cardiopulmonary resuscitation (cCPR).

Aim

Our systematic review and meta-analysis seek to compare outcomes of cCPR versus eCPR in patients with out-of-hospital cardiac arrest (OHCA).

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in this study and the questionnaire utilized the PICO (Patient, Intervention, Control, Outcome) framework. A search strategy using MeSH (Medical Subject Headings) terms was made from which Pubmed/Medline, SCOPUS, and Cochrane Library were searched from inception till March 2024 to reveal all relevant studies. Conference proceedings, www.clinicaltrials.gov, and bibliometrics of published articles were also searched for gray literature.

Results

Compared with conventional CPR (cCPR), extracorporeal CPR (eCPR) was associated with higher odds of favorable neurological outcome at discharge (OR 2.61, 95% CI 1.28–5.32; p = 0.008; I²=82%), 3-months (OR 3.29, 95% CI 1.63–6.63; p = 0.0009; I²=46%), and 6-months (OR 1.97, 95% CI 1.24–3.12; p = 0.004; I²=12%). The increase at 1-month was not significant (OR 2.15, 95% CI 0.87–5.34; p = 0.10; I²=90%). eCPR also improved survival-to-discharge (OR 1.84, 95% CI 1.17–2.92; p = 0.009; I²=73%).

Conclusion

eCPR in the management of OHCA patients has more favorable neurological and survival outcomes as compared to cCPR.