CPR Almost Always Fails. ECPR Is a Different Story

Dramatic TV rescues notwithstanding, the stark truth is that people who go into cardiac arrest are usually doomed. CPR is almost always futile. Defibrillators can shock a heart back to life, but only if the patient has a "shockable rhythm" to work with, writes physician Helen Ouyang in the New York Times Magazine. As a result, only about 9% of people in cardiac arrest who even make it to the hospital make it back out. Her story, and an accompanying explainer, focus on another method gaining traction—ECPR, or extracorporeal cardiopulmonary resuscitation—that has some remarkable stats. Patients have a nearly 100% chance of survival, with brain function intact, if they are treated within 30 minutes of collapsing, writes Ouyang. Even at 40 minutes, they have a 50% chance of survival, in contrast to the "essentially nil" chance without ECPR at that point.

The method involves connecting a patient to an extracorporeal membrane oxygenation (ECMO) machine, which functions as their heart and lungs, keeping the person alive long enough for doctors to fix the underlying problem. "Big picture, ECPR is the most effective intervention for cardiac arrest since CPR," Joseph Tonna, an ER doctor at the University of Utah Health, tells Ouyang. The problem, he adds, it that "it's actually pretty hard to implement." As Ouyang explains, ECPR "is a highly specialized, complex procedure that most doctors do not know how to do," one that involves inserting tubes into patients' blood vessels and running them from the groin to the heart. As a result, only a relative handful of hospitals around the US use the procedure, though that could change as advances continue, including with mobile ECPR units. Read the full story. (Or check out other longform recaps.)