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Shortening the path to perfusion: why every link in the chain of survival shapes ECPR outcomes

  • Fabio Sangalli1,2,*,
  • Antonio Rubino3

1Department of Anaesthesiology and Intensive Care, ASST Brianza, 20871 Vimercate, Italy

2University of Milano-Bicocca, 20126 Milan, Italy

3Department of Anaesthesiology and Intensive Care, Royal Papworth Hospital NHS Foundation Trust, CB20AY Cambridge, UK

DOI: 10.22514/sv.2026.022

Submitted: 10 December 2025 Accepted: 06 February 2026

Online publish date: 20 March 2026

*Corresponding Author(s): Fabio Sangalli E-mail: fabio.sangalli@unimib.it

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Keywords

Cardiac arrest; Extracorporeal life support; Resuscitation; Extracorporeal membrane oxygenation; Cardiopulmonary resuscitation; Life support; Defibrillation


Cite and Share

Fabio Sangalli,Antonio Rubino. Shortening the path to perfusion: why every link in the chain of survival shapes ECPR outcomes. Signa Vitae. 2026.doi:10.22514/sv.2026.022.

URL:

https://www.signavitae.com/articles/10.22514/sv.2026.022

References

[1] Liao Q, Liu Q, Li S, He H, Bao R, Gu X, et al. Impact of the interval between cardiopulmonary resuscitation and veno-arterial extracorporeal membrane oxygenation on in-hospital mortality in adult patients after cardiac arrest. Signa Vitae. Forthcoming 2026.

[2] Greif R, Lauridsen KG, Djärv T, Ek JE, Monnelly V, Monsieurs KG, et al.; European Resuscitation Council Guidelines 2025 Collaborator Group. European resuscitation council guidelines 2025 executive summary. Resuscitation. 2025; 215: 110770.

[3] Del Rios M, Bartos JA, Panchal AR, Atkins DL, Cabañas JG, Cao D, et al. Part 1: executive summary: 2025 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2025; 152: S284–S312.

[4] Goto Y, Funada A, Goto Y. Relationship between the duration of cardiopulmonary resuscitation and favorable neurological outcomes after out-of-hospital cardiac arrest: a prospective, nationwide, population-based cohort study. Journal of the American Heart Association. 2016; 5: e002819.

[5] Yannopoulos D, Bartos J, Raveendran G, Walser E, Connett J, Murray TA, et al. Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trial. The Lancet. 2020; 396: 1807–1816.

[6] Belohlavek J, Smalcova J, Rob D, Franek O, Smid O, Pokorna M, et al.; Prague OHCA Study Group. Effect of intra-arrest transport, extracorporeal cardiopulmonary resuscitation, and immediate invasive assessment and treatment on functional neurologic outcome in refractory out-of-hospital cardiac arrest: a randomized clinical trial. JAMA. 2022; 327: 737–747.

[7] Nakatsutsumi K, Endo A, Costantini TW, Takayama W, Morishita K, Otomo Y, et al.; SAVE-J II study group. Time-saving effect of real-time ultrasound-guided cannulation for extracorporeal cardiopulmonary resuscitation: a multicenter retrospective cohort study. Resuscitation. 2023; 191: 109927.

[8] Bertini P, Sangalli F, Meani P, Marabotti A, Rubino A, Scolletta S, et al.; ITACTAIC. Establishing an extracorporeal cardiopulmonary resuscitation program. Medicina. 2024; 60: 1979.


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