On-scene ECMO for out-of-hospital cardiac arrest in the Moravian-Silesian Region

Prehospital ECPR in Moravia Silesia Region - Assessing the Effectiveness, Feasibility and Time of ECPR by Simulating Connections and Real Interventions.

This project will try starting ECMO (mechanical heart-lung support) on scene for adults who have a witnessed out-of-hospital cardiac arrest to see if earlier support improves outcomes.

Quick facts

• Study type: Observational
• Enrollment: 100 (estimated)
• Ages: 18 Years to 70 Years
• Sex: All
• Sponsor: University Hospital Ostrava (Academic / other)
• Locations: 2 sites (Ostrava, Moravian-Silesian Region and 1 other locations)
• Trial ID: NCT07041086 on ClinicalTrials.gov

What this trial studies

This observational program deploys an ECMO team to selected out-of-hospital cardiac arrests in the Moravian-Silesian Region so patients can be connected to extracorporeal membrane oxygenation in the field rather than waiting for in-hospital implantation. Eligible adult patients are those with witnessed collapse of presumed cardiac cause, initial ventricular fibrillation or PEA, bystander CPR, and without major comorbidities or low body weight. The approach aims to shorten the time from collapse to ECMO initiation, a key factor thought to influence neurological recovery and survival. Data collected will compare field ECPR timing and outcomes to historical or contemporaneous in-hospital ECPR experience at University Hospital Ostrava.

Who should consider this trial

Good fit: Adults aged 18–70 with a witnessed, presumably cardiac out-of-hospital arrest, initial rhythm of ventricular fibrillation or PEA, receiving bystander or telephone-assisted CPR, and without major terminal comorbidities or very low body weight are ideal candidates.

Not a fit: Patients with unwitnessed arrests, clearly non-cardiac causes, severe chronic comorbidities, estimated age over 70, or weight under 40 kg are unlikely to benefit from prehospital ECMO in this program.

Why it matters

Potential benefit: If successful, on-scene ECMO could substantially increase the chance of survival with good neurological recovery by reducing the time without full blood perfusion.

How similar studies have performed: Prehospital ECPR models have been adopted in several other regions abroad and observational reports suggest improved neurological outcomes in selected patients, though randomized evidence remains limited.

Eligibility criteria

Inclusion Criteria:

* Age ≥ 18 years
* Observed collapse and presumption of cardiac cause of cardiac arrest
* Estimated age up to 70 years
* Baseline rhythm of ventricular fibrillation or pulseless electrical activity (PEA)
* Basic bystander cardiopulmonary resuscitation (CPR), "bystander CPR", telephone assisted CPR (TANR)

Exclusion Criteria:

* Children or adults with estimated weight below 40 kg
* Known major comorbidities of the patient suggesting low rehabilitation potential (e.g. chronic obstructive pulmonary disease (COPD) IV, malignancy in tertiary phase)

Where this trial is running

Ostrava, Moravian-Silesian Region and 1 other locations

• Emergency Medical Services, Moravian-Silesian Region — Ostrava, Moravian-Silesian Region, Czechia (Recruiting)
• University Hospital Ostrava — Ostrava, Moravian-Silesian Region, Czechia (Recruiting)

Study contacts

• Principal investigator: Filip Burša, MD, PhD, EDEC — University Hospital Ostrava
• Study coordinator: Jiří Hynčica

Conditions Cardiac Arrest, Out-Of-Hospital; ECMO; Cardiac arrest; Cardiopulmonary resuscitation