Early initiation of extracorporeal life support in refractory out-of-hospital cardiac arrest: Design and rationale of the INCEPTION trial

Martine E. Bol, Martje M. Suverein*, Roberto Lorusso, Thijs S. R. Delnoij, George J. Brandon Bravo Bruinsma, Luuk Otterspoor, Marijn Kuijpers, Ka Yan Lam, Alexander P. J. Vlaar, Carlos V. Elzo Kraemer, Joris J. van der Heijden, Erik Scholten, Antoine H. G. Driessen, Jose M. Montero Cabezas, Saskia Z. H. Rittersma, Bram G. Heijnen, Fabio S. Taccone, Brigitte Essers, Tammo Delhaas, Patrick W. WeerwindPaul M. H. J. Roekaerts, Jos G. Maessen, Marcel C. G. van de Poll

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

23 Citations (Web of Science)


Background Return of spontaneous circulation occurs in less than 10% of patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR) for more than 15 minutes. Studies suggest that extracorporeal life support during cardiopulmonary resuscitation (ECPR) improves survival rate in these patients. These studies, however, are hampered by their non-randomized, observational design and are mostly single-center. A multicenter, randomized controlled trial is urgently warranted to evaluate the effectiveness of ECPR.

Hypothesis We hypothesize that early initiation of ECPR in refractory out-of-hospital cardiac arrest (OHCA) improves the survival rate with favorable neurological status.

Study design The INCEPTION trial is an investigator-initiated, prospective, multicenter trial that will randomly allocate 110 patients to either continued CPR or ECPR in a 1: 1 ratio. Patients eligible for inclusion are adults (

Summary The INCEPTION trial aims to determine the clinical benefit for the use of ECPR in patients with refractory OHCA presenting with VF/VT. Additionally, the feasibility and cost-effectiveness of ECPR will be evaluated.

Original languageEnglish
Pages (from-to)58-68
Number of pages11
JournalAmerican Heart Journal
Publication statusPublished - Apr 2019


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