Table 1.

Categorization of the mode of death in extracorporeal cardiopulmonary resuscitation (ECPR) patients. Adaptation of reasons for death following ECPR of the categories adopted from Witten et al. [6].

Reasons for Death Following ECPR in Five Categories
Neurological Withdrawal	Withdrawal of care based on expectations of a poor neurological recovery. If an assessment off sedation is not done, e.g., in the early hours during targeted temperature management (TTM), there must be other evidence of severe neurologic injury (e.g., severe cerebral edema or herniation).
Persisting Cardiogenic/Post-Resuscitation Shock	Withdrawal from therapy in either progressive, refractory hemodynamic shock due to refractory vasoplegia in post-resuscitation shock, with inadequate VA-ECMO despite aggressive catecholamine therapy and volume substitution. Or, Withdrawal in case of lack of hemodynamic stabilization with persisting dependency of a cardiac support system (VA-ECMO or Impella®) without the possibility of definitive care using an LV-assist device (LVAD) or heart transplantation.
Multi-Organ Failure	Withdrawal of therapy due to a multi-organ failure (for example in the context of an uncontrollable septic shock) or persistent liver failure.
Respiratory Failure	Withdrawal of care based on respiratory failure. Respiratory failure with hypoxemia, hypercapnia or a combination of these despite maximum support with respirator plus VA-ECMO or even VVA-ECMO.
Presumed Patients Will	This category includes the withdrawal if the patient’s presumed will was against resuscitation. Or, Withdrawal of therapy and termination of intensive care treatment due to an expected poor quality of life (e.g., in context of previously existing serious illness such as dementia or an advanced cancer disease).

VA-ECMO—veno-arterial extracorporeal membrane oxygenation; LVAD—left ventricular assist device; TTM—targeted temperature management; VVA-ECMO—veno-veno-arterial extracorporeal membrane oxygenation.