Project name: Implementation of a pre-hospital extracorporeal cardiopulmonary resuscitation system to ensure the availability of highly specialized care for patients with cardiac arrest

Project start date: 1. 5. 2025
Project completion date: 30. 6. 2028
Project budget - subsidies for VFN: 47,545,496.40 CZK
Project guarantor: 2nd Department of Internal Medicine, Prof. MUDr. Jan Bělohlávek, Ph.D.
Project Registration Number: CZ.03.02.02/00/25_102/0005580

Project brief:

The project is supported under the 102nd call of the Operational Program Employment Plus.

The main objective of the project is to ensure the availability of timely highly specialized care for patients with refractory cardiac arrest by implementing a pre-hospital extracorporeal cardiopulmonary resuscitation (ECPR) system with the aim of increasing the chances of these patients surviving with a good neurological outcome and ensuring subsequent comprehensive, long-term, specialized hospital and outpatient care for the high-risk population of resuscitated patients.

Sudden cardiac death is one of the most common causes of death in the Czech Republic and Europe. In Europe, the estimated incidence of sudden cardiac death is 86 per 100,000 inhabitants per year, corresponding to up to 10,000 deaths per year in the Czech Republic. Despite all the advances in the prevention and treatment of cardiovascular diseases, the mortality rate of patients from cardiac arrest remains very high. Most patients do not respond to standard cardiopulmonary resuscitation (blood circulation is not restored) and die at the scene of cardiac arrest.

Sudden cardiac arrest affects patients of all ages, socioeconomic groups, genders, and races, and significantly impacts their subsequent functioning in society. The disability caused by cardiac arrest and suboptimal recovery and resocialization also negatively impacts family members and caregivers, thereby impairing their functioning in society.

ECPR is a life-saving treatment modality that has shown benefit in several observational and two randomized studies of hospital ECPR (Prague OHCA Study and Arrest) compared with conventional resuscitation. Early prehospital or in-hospital invasive resuscitation based on ECPR should be considered as the first-line treatment for these patients within large, well-organized care systems. The latest update of the American guidelines for resuscitation from 2024 thus states the appropriateness of considering ECPR for patients with out-of-hospital cardiac arrest in well-established and functioning prehospital and post-hospital care systems.

Sub-objectives and activities of the project:

• Creating a pre-hospital ECPR system
• Implementation of highly specialized post-resuscitation hospital care
• Highly specialized post-resuscitation outpatient care and social inclusion
• Dissemination of project results in the form of preparation of 2 professional publications (1 foreign Q1, the second domestic in a peer-reviewed journal) and a draft protocol/recommendation for the implementation of the ECPR method in all comprehensive cardiac centers and pre-hospital ECPR in other cities and regions with the aim of increasing the chances of survival of patients with out-of-hospital cardiac arrest.

We assume that during the three years of project implementation, pre-hospital ECPR will be provided to approximately 70-90 patients, and patients will subsequently undergo comprehensive intensive post-resuscitation care and will be monitored for a long time in a specialized outpatient clinic for post-resuscitation care. Patients will also be provided with comprehensive cardiological, rehabilitation, psychological and palliative care.  

The project will also include a pre-hospital ECPR simulation course for emergency medical crews, implemented in a simulation center that allows active training with simulators, trainers, and phantoms.