ECPR for OHCA in Singapore: Cost-Effective, but Sensitive to Transport Delays

Refractory out-of-hospital cardiac arrest (OHCA) continues to present a formidable challenge in emergency medicine, with persistently poor outcomes despite advances in conventional cardiopulmonary resuscitation (CPR) [1, 2]. For select patients, extracorporeal cardiopulmonary resuscitation (ECPR), which uses venoarterial extracorporeal membrane oxygenation to provide circulatory support, has emerged as a potential rescue therapy [3, 4]. Recent analyses suggest ECPR may improve survival with favorable neurological outcomes, especially for patients with initial shockable rhythms and brief low-flow times [5, 6, 7]. However, the significant resources required for ECPR, including specialized personnel, equipment, and extended hospitalizations, create substantial questions about its economic sustainability [8]. A new modeling study from Singapore now provides a detailed analysis of these critical cost-effectiveness considerations.