Selecting the appropriate candidates for extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) is challenging. Previously, the Extracorporeal Life Support Organization (ELSO) guidelines suggested the example of inclusion criteria. However, it is unclear whether patients who meet the inclusion criteria of the ELSO guidelines have more favorable outcomes. We aimed to evaluate the relationship between the outcomes and select inclusion criteria of the ELSO guidelines. We conducted a post-hoc analysis of a multicenter prospective study conducted between 2019 and 2021. Adult patients with OHCA treated with ECPR were included. The primary outcome was a favorable neurological outcome (Cerebral Performance Category of 1 or 2) at 30 days. An ELSO criteria score was assigned based on four criteria: (i) age < 70 years; (ii) witness; (iii) bystander CPR; and (iv) low-flow time (<60 min). Subgroup analysis based on initial cardiac rhythm was performed. Among 9,909 patients, 227 with OHCA were included. The proportion of favorable neurological outcomes according to the number of ELSO criteria met were: 0.0% (0/3), 0 points; 0.0% (0/23), 1 point; 3.0% (2/67), 2 points; 7.3% (6/82), 3 points; and 16.3% (7/43), 4 points. A similar tendency was observed in patients with an initial shockable rhythm. However, no such relationship was observed in those with an initial non-shockable rhythm. Patients who adhered more closely to specific inclusion criteria of the ELSO guidelines demonstrated a tendency towards a higher rate of favorable neurological outcomes. However, the relationship was heterogeneous according to initial rhythm.

中文翻译：

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评估 ELSO 指南的遵守对因院外心脏骤停而需要体外心肺复苏的患者的良好神经学结局的影响


为院外心脏骤停 (OHCA) 选择合适的体外心肺复苏 (ECPR) 候选人具有挑战性。此前，体外生命支持组织（ELSO）指南建议了纳入标准的示例。然而，尚不清楚符合 ELSO 指南纳入标准的患者是否有更有利的结果。我们的目的是评估结果之间的关系并选择 ELSO 指南的纳入标准。我们对 2019 年至 2021 年间进行的一项多中心前瞻性研究进行了事后分析。纳入了接受 ECPR 治疗的成人 OHCA 患者。主要结果是 30 天时良好的神经系统结果（大脑表现类别 1 或 2）。 ELSO 标准分数是根据四个标准分配的：(i) 年龄 < 70 岁； (二) 证人； (iii) 旁观者心肺复苏术； (iv) 低流量时间（<60 分钟）。进行了基于初始心律的亚组分析。在 9,909 名患者中，包括 227 名 OHCA 患者。根据满足 ELSO 标准的数量，良好的神经学结果比例为：0.0%（0/3），0 分； 0.0%（0/23），1分； 3.0%（2/67），2分； 7.3%（6/82），3分； 16.3% (7/43)，4 分。在初始可电击节律的患者中也观察到类似的趋势。然而，在初始不可电击节律的患者中没有观察到这种关系。更严格遵守 ELSO 指南特定纳入标准的患者表现出较高比例的良好神经学结果的趋势。然而，根据最初的节奏，这种关系是异质的。