Impact of timeliness of extracorporeal cardiopulmonary resuscitation on patients' survival outcomes

Liu Yuanyuan; Jia Ming; Du Zhongtao; Xu Bo; Li Chenglong; Liu Lintian; Wang Liangshan; Wang Mengjun; Hou Xiaotong

doi:10.3760/j.issn.1673-4777.2026.03.001

Abstract：Objective To investigate the correlation between the optimization of emergency timeliness and survival outcomes in patients undergoing extracorporeal cardiopulmonary resuscitation(ECPR),and to provide evidence-based medical evidence for the establishment of an efficient ECPR rapid response system.Methods The clinical data of 167 critically ill patients who underwent ECPR treatment at Beijing Anzhen Hospital,Capital Medical University from January 2017 to December 2024 were retrospectively analyzed.Key indicators including the extracorporeal membrane oxygenation(ECMO)initiation time(the time from the ECMO team receiving the emergency call to start the emergency process to the successful initiation of ECMO),installation location and catheterization method were recorded,and their relationships with clinical outcomes such as in-hospital mortality and weaning success rate were analyzed.Results The in-hospital mortality rate was 71.9％(120/167)and the weaning success rate was 41.9％(70/167)among the 167 ECPR patients.The ECMO initiation time was shorter in the operating room and intensive care unit,and the longest in the emergency department,with no statistically significant difference(P=0.131).The initiation time of pre-catheterization and percutaneous puncture was signifi-cantly shorter than that of incision,puncture combined with incision(all P＜0.05).The initiation time of in-hos-pital survivors was significantly shorter than that of in-hospital non-survivors[30.00(21.00,40.00)min vs 35.00(26.00,48.00)min](Z=-2.275,P=0.023).The initiation time of successful weaning patients was also significantly shorter than that of unsuccessful weaning patients[30.00(21.00,40.50)min vs 35.00(28.00,49.00)min](Z=-2.223,P=0.026).Multivariate Logistic regression analysis showed that catheterization method was the only independent risk factor affecting ECPR initiation time(hazard ratio=2.273,95％confidence interval:1.354-3.815,P=0.002).Logistic regression model analysis showed that when the initiation time was 40 min,the risk of death in patients increased significantly and the weaning success rate decreased significantly(all P＜0.05).Conclusion Initiation time is a key factor affecting the prognosis of ECPR patients.The application of percutaneous puncture catheterization technology and optimization of initiation time(controlled within 40 min)can significantly improve the survival outcomes of patients.Medical institutions should establish a professional ECPR rapid response team,formulate standardized emergency processes,and improve the rescue success rate of patients with refractory cardiac arrest.