Use of extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest in patients – a literature review

Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising treatment for patients with out-of-hospital cardiac arrest (OHCA) when conventional methods fail. 
The inclusion of patients with initial pulse less electrical activity (PEA) is controversial due to inferior outcomes compared to those with shockable initial rhythm. In this review, we aimed to summarize the experience with the use of ECPR in patients with initial PEA. 
Although studies report poor survival in this subgroup, factors such as underlying cause of arrest, rhythm conversion, and duration of low-flow time influence outcomes. Further research is needed to refine patient selection and optimize the timing of ECPR to improve survival and neurological recovery.