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To identify the predictors of survival to discharge in adults resuscitated with extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest (IHCA).

MEDLINE and ISI Web of Science were searched for eligible studies. Pooled Odds Ratio (OR) and Pooled Mean Difference (PMD) for each predictor were calculated. The quality of evidence (QOE) was evaluated according to the GRADE guidelines.

Eleven studies were included totalling 856 patients. Of these, 324 (37.9%) survived to discharge. Good neurological outcome (Cerebral Performance Category 1 or 2) occurred in 222/263 (84.4%) survivors. Survival was associated with significantly higher odds of an initial shockable rhythm (OR 1.65; 95% confidence interval [95%CI] 1.05–2.61; p = 0.03), shorter low-flow time (PMD −17.15 [−20.90, −13.40] min; p < 0.00001), lower lactate levels both immediately before ECPR start …