{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:36:47Z","timestamp":1791934607655,"version":"4.3.4"},"reference-count":29,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Membranes"],"abstract":"<jats:p>Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) might be a lifesaving therapy for patients with cardiac arrest and no return of spontaneous circulation during advanced life support. However, even with ECPR, mortality of these severely sick patients is high. Little is known on the exact mode of death in these patients. Methods: Retrospective registry analysis of all consecutive patients undergoing ECPR between May 2011 and May 2020 at a single center. Mode of death was judged by two researchers. Results: A total of 274 ECPR cases were included (age 60.0 years, 47.1% shockable initial rhythm, median time-to-extracorporeal membrane oxygenation (ECMO) 53.8min, hospital survival 25.9%). The 71 survivors had shorter time-to-ECMO durations (46.0 \u00b1 27.9 vs. 56.6 \u00b1 28.8min, p &lt; 0.01), lower initial lactate levels (7.9 \u00b1 4.5 vs. 11.6 \u00b1 8.4 mg\/dL, p &lt; 0.01), higher PREDICT-6h (41.7 \u00b1 17.0% vs. 25.3 \u00b1 19.0%, p &lt; 0.01), and SAVE (0.4 \u00b1 4.8 vs. \u22120.8 \u00b1 4.4, p &lt; 0.01) scores. Most common mode of death in 203 deceased patients was therapy resistant shock in 105\/203 (51.7%) and anoxic brain injury in 69\/203 (34.0%). Comparing patients deceased with shock to those with cerebral damage, patients with shock were significantly older (63.2 \u00b1 11.5 vs. 54.3 \u00b1 16.5 years, p &lt; 0.01), more frequently resuscitated in-hospital (64.4% vs. 29.9%, p &lt; 0.01) and had shorter time-to-ECMO durations (52.3 \u00b1 26.8 vs. 69.3 \u00b1 29.1min p &lt; 0.01). Conclusions: Most patients after ECPR decease due to refractory shock. Older patients with in-hospital cardiac arrest might be prone to development of refractory shock. Only a minority die from cerebral damage. Research should focus on preventing post-CPR shock and treating the shock in these patients.<\/jats:p>","DOI":"10.3390\/membranes11040270","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T21:27:44Z","timestamp":1617917264000},"page":"270","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Mode of Death after Extracorporeal Cardiopulmonary Resuscitation"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1335-4732","authenticated-orcid":false,"given":"Viviane","family":"Zotzmann","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Bemtgen","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8638-5228","authenticated-orcid":false,"given":"Markus","family":"J\u00e4ckel","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabelle","family":"Fluegler","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9333-3629","authenticated-orcid":false,"given":"Jonathan","family":"Rilinger","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Benk","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery (University Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Bode","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Supady","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Institute of Global Health, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3659-0407","authenticated-orcid":false,"given":"Tobias","family":"Wengenmayer","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawid","family":"Staudacher","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology I (Heart Center Freiburg\u2014Bad Krozingen), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"},{"name":"Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-020-2773-2","article-title":"The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: A systematic review and meta-analysis","volume":"24","author":"Yan","year":"2020","journal-title":"Crit. 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