Cardiac arrest impacts more than 500,000 people in the United States annually. Overall, cardiac arrest, particularly when it occurs outside of a hospital, is associated with low rates of survival and poor neurologic recovery. Extracorporeal cardiopulmonary resuscitation (ECPR), or the use of extracorporeal membrane oxygenation (ECMO) during the cardiopulmonary resuscitation (CPR) process, has increased in recent years. The Extracorporeal Resuscitation Outcomes Database (EROD) aims to serve as a source of highly detailed, granular data for research on ECPR. This paper represents the inaugural report from EROD.

We created EROD, which collects prospective data on adult cardiac arrest cases treated with ECPR, including demographics, medical history, cardiac arrest characteristics, the ECMO cannulation process, post-cannulation care, hospital treatments and diagnostics, neuroprognostication, complications, and outcomes.

Five centers in North America contributed data (n = 113) to EROD between March 2017 and March 2022. The majority White (64%) and male (78%) sample had a significant medical history prior to their cardiac arrest (73%). Most patients arrested pre-hospital (65%) and received bystander CPR (81%). ECMO cannulation most often took place in an emergency department (67%) and was done by a Cardiothoracic Surgery provider (76%). Common complications included acute kidney injury (49%), major bleeding (29%), vascular injury (19%), and limb ischemia (14%), among others. One quarter of patients survived to hospital discharge (25%) and had an average hospital length of stay of 22 days (SD 15.5). Of the whole sample, there was an average time of 84 min from time of cardiac arrest to ECMO cannulation (SD 54) and patients spent an average of 107 h and 56 min on ECMO (SD 73:53). Of the 25% who survived (n = 28), the majority had positive neurologic outcomes with a Cerebral Performance Category (CPC) score of 1 (n = 15), indicating no or mild cerebral disability, or a CPC of 2 (n = 5), indicating moderate cerebral disability.

This paper introduces EROD and presents data from the initial 113 patients entered into the registry from 2017 to 2022. Initial analysis demonstrated survival rates that align with national averages, even with longer durations of CPR prior to ECMO cannulation. Utilization of this registry, as well as others, is crucial in identifying and establishing standardized ECPR practices that deliver the best possible outcomes for patients.