Please select the eligibility criteria that correspond to the clinical trial below.
Title: Early Initiation of Extracorporeal Life Support in Refractory OHCA (INCEPTION)
Brief Summary: Despite adequate conventional cardiopulmonary resuscitation (CCPR) and attempted defibrillation, a considerable number of patients in cardiac arrest fail to achieve sustained return of spontaneous circulation. The INCEPTION trial is a multicenter, randomized controlled trial that will explore extracorporeal cardiopulmonary resuscitation (ECPR) in patients in refractory out-of-hospital cardiac arrest (OHCA) presenting with ventricular fibrillation or tachycardia. It aims to determine the effect on survival and neurological outcome. Additionally, it will evaluate the feasibility and cost-effectiveness of ECPR.


Options:
A: Inclusion Criteria:

1. ≥18 - ≤70 years
2. Witnessed OHCA (by bystanders)
3. Initial rhythm of VF/VT or AED administered
4. Bystander BLS

Exclusion Criteria:

1. ROSC within 15 minutes of conventional CPR with sustained hemodynamic recovery
2. Terminal heart failure (NYHA III or IV)
3. Severe pulmonary disease (COPD GIII of GIV)
4. Disseminated oncological disease
5. Obvious or suspected pregnancy
6. Bilateral femoral bypass surgery
7. Known contraindications for ECPR
8. Known pre-arrest CPC-score of 3 or 4
9. Known limitations in therapy or a Do Not Resuscitate-order
10. Multitrauma (Injury Severity Score \>15)
11. Expected time-to-start cannulation \> 60 minutes
B: Inclusion Criteria:

* Mechanical ventilation with expected duration of \>24h
* Moderate ARDS according to the Berlin definition(16) PaO2/FiO2: 200-100 mmHg, with PEEP ≥ 5 cmH2O

Exclusion Criteria:

* Age \<18 years
* Pregnancy
* Decompensated heart insufficiency or acute coronary syndrome
* Severe COPD
* Major respiratory acidosis PaCO2\>60 mmHg
* Acute brain injury
* Severe liver insufficiency (Child-Pugh scores \>7) or fulminant hepatic failure
* Heparin-induced thrombocytopenia
* Contraindication for systemic anticoagulation
* Patient moribund, decision to limit therapeutic interventions
* Catheter access to femoral vein or jugular vein impossible
* Pneumothorax
* Platelet \<50 G/l
C: Inclusion Criteria:

* All patients admitted to the participating ICUs receiving invasive or non-invasive ventilation will be screened and included in the database.

Exclusion Criteria:

* Age \< 16
D: Inclusion Criteria:

* Age ≥ 18 years
* Intubated patients with cardiogenic shock treated with VA-ECMO
* Patient affiliated to social security plan

Exclusion Criteria:

* VA-ECMO after cardiac surgery for heart transplantation or lung transplantation or left or biventricular assist device implantation
* VA-ECMO for acute poisoning with cardio-toxic drugs
* Pregnancy
* Uncontrolled bleeding (bleeding despite medical intervention (surgery or drugs))
* Implantation of VA ECMO under cardiac massage with a duration of cardiac massage \>45minutes
* Out of hospital refractory cardiac arrest
* Cerebral deficit with fixed dilated pupils
* Participation in another interventional research involving therapeutic modifications
* Patient moribund on the day of randomization
* Irreversible neurological pathology
* Minor patients
* Patients under tutelage

Answer: A