Among patients with refractory out-of-hospital cardiac arrest, the bundle of early intra-arrest transport, extracorporeal cardiopulmonary resuscitation (ECPR), and invasive assessment and treatment did not significantly improve survival with neurologically favorable outcome at 180 days compared with standard resuscitation. However, the trial was possibly underpowered to detect a clinically relevant difference.

The trial was stopped at the recommendation of the data and safety monitoring board when prespecified criteria for futility were met.

Among 256 patients, 256 (100%) completed the trial.

In the main analysis, 39 patients (31.5%) in the invasive strategy group and 29 (22.0%) in the standard strategy group survived to 180 days with good neurologic outcome.

At 30 days, neurologic recovery had occurred in 38 patients (30.6%) in the invasive strategy group and in 24 (18.2%) in the standard strategy group, and cardiac recovery had occurred in 54 (43.5%) and 45 (34.1%) patients, respectively.

Bleeding occurred more frequently in the invasive strategy vs standard strategy group.

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