# Building an ECMO/ECPR Pathway—Operational Metrics and Patient Outcomes in One Year

## TL;DR

This paper evaluates the outcomes and operational efficiency of an ECMO program at a Latvian hospital over one year.

## Contribution

The study provides insights into patient outcomes and operational metrics of an ECMO/ECPR pathway in a real-world hospital setting.

## Key findings

- Seven out of fifteen patients did not survive to hospital discharge.
- First lactate and troponin levels after ECMO cannulation were statistically significant.
- CHF, survival to ECMO decannulation, and ICU discharge were significant qualitative outcomes.

## Abstract

Background/Objectives: Pauls Stradins Clinical University Hospital in Riga, Latvia, introduced an ECMO program in 2008. Since the program’s start, countless patients have had their lives saved by this necessary technology. Our goal was to review the ECMO program results and gain insight into the organization’s operations. We wanted not only to assess the program’s efficiency in terms of time, but also to visualize patient outcomes at least a month after decannulation from ECMO and discharge from the hospital. Methods: A retrospective observational study was performed using hospital patient data files from October 2024 to October 2025. The selected patient group was those who had suffered an in-hospital cardiac arrest and successfully had ECMO inserted; this criterion fit fifteen patients. Data were collected on multiple factors, including from collapse to flow time, the number of days spent in the ICU, and post-ECMO complications. Afterwards, the data were analyzed to understand the program’s and patients’ outcomes. Results: Of the fifteen patients analyzed, seven did not survive to hospital discharge. The statistically significant quantitative results were the first lactate levels after ECMO cannulation and the first troponin levels after cardiac arrest. In terms of qualitative results, CHF, survival to ECMO decannulation, cannulation failure, and survival to ICU discharge were statistically significant. Conclusions: The ECMO program at Pauls Stradins Clinical University Hospital provides patients with a necessary technology after an intra-hospital cardiac arrest. This study highlights data about these patients and their outcomes, as well as areas for improvement within the hospital’s ECMO/ECPR program.