Home › Cardiac arrest › Loss of pulsatility predicts death after ECPR

Cardiac arrest

Loss of pulsatility predicts death after ECPR

Incidence and impact of loss of pulsatility on outcomes after extracorporeal cardiopulmonary resuscitation – A retrospective cohort study
Resuscitation Plus · Added 18 August 2026

Retrospective cohort of 221 ECPR patients found loss of pulsatility (zero pulse pressure) occurred in 49% of cases and was associated with significantly higher in-hospital mortality (74% vs 48%), with each additional hour of non-pulsatility increasing mortality risk by 17%

Study type

Cohort

Design

Retrospective single-centre cohort

Participants

221 ECPR patients

Main finding

Loss of pulsatility occurred in 49% (108/221); in-hospital mortality 74% vs 48% (p=0.01); each additional hour of non-pulsatility increased mortality risk (OR 1.17, 95% CI 1.05–1.30)

Caveat

Retrospective, single high-volume ECMO centre; loss of pulsatility group had more OHCA and longer arrest-to-ECMO times

Bottom line

Hypothesis-generating

Learning goal

Recognise the risks of loss of pulsatility during resuscitation and how prolonged non-pulsatility shapes outcomes after refractory arrest.

More

• Topic: Cardiac arrest
• Daily scan: 18 August 2026

Related papers on Cardiac arrest

• Double sequential defibrillation shows no benefit

  Resuscitation · 23 Aug 2026 · Cohort · Supports current practice

  NZ EMS observational study (n=1,401) found no survival benefit after DSD implementation for refractory VF/VT, with lower ROSC odds in DSD patients likely reflecting confounding by indication.

• Prolonged fasting raises defibrillation needs in pigs

  Resuscitation Plus · 18 Aug 2026 · Simulation · Hypothesis-generating

  Porcine model of ventricular fibrillation cardiac arrest found that prolonged fasting-induced lower pre-arrest glycemia was associated with increased defibrillation requirements (median 2 vs 1 shock) and longer CPR duration, despite similar sustained ROSC rates.

• CPR leader app no help in simulation

  Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · 18 Aug 2026 · Simulation · Context only

  Randomized simulation trial of 40 teams testing the 'CPR Leader' app during in-hospital cardiac arrest found no meaningful improvement in team performance, non-technical skills, or ALS algorithm adherence compared to control

• New Penang OHCA registry shows low survival

  Resuscitation Plus · 16 Aug 2026 · Registry · Context only

  Descriptive analysis of 5,087 OHCA cases showed 16.3% received EMS resuscitation attempts, with only 1.3% 30-day survival despite bystander CPR in 43.5% of cases, and AED deployment in only 7.1%.