Abstract
For selected patients with refractory out-of-hospital cardiac arrest (OHCA), extracorporeal cardiopulmonary resuscitation (eCPR) has emerged as a life-saving option, requiring comprehensive organization and collaboration between emergency medical services (EMS) and eCPR-receiving centers. Although various eCPR criteria have been proposed for refractory OHCA, the decision to initiate eCPR remains highly challenging. We present the case of a female patient with mild cognitive impairment who survived 110 minutes of resuscitation for pulmonary embolism, with a neurologically favorable outcome, achieved through coordinated teamwork between pre-hospital and in-hospital care.