Trial Of Continuous Compressions Versus Standard CPR In Patients With Out-Of-Hospital Cardiac Arrest
Overview
- Phase
- Phase 4
- Intervention
- Not specified
- Conditions
- Out of Hospital Cardiac Arrest
- Sponsor
- University of Washington
- Enrollment
- 23711
- Locations
- 7
- Primary Endpoint
- Number of Participants Who Survive From the Time of Cardiac Arrest to Hospital Discharge
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
The primary aim of the trial is to compare survival to hospital discharge after continuous chest compressions (CCC) versus standard American Heart Association (AHA) recommended cardiopulmonary resuscitation (CPR) with interrupted chest compressions (ICC) in patients with out-of-hospital cardiac arrest (OOHCA). The primary null hypothesis will be that the rate of survival to hospital discharge is not affected by use of continuous compressions with passive or positive pressure ventilation (intervention group) versus CPR with compressions interrupted for ventilation at a ratio of 30:2 (control group).
Detailed Description
The primary aim of the trial is to compare survival to hospital discharge after continuous chest compressions (CCC) versus standard American Heart Association (AHA) recommended cardiopulmonary resuscitation (CPR) with interrupted chest compressions (ICC) in patients with out-of-hospital cardiac arrest (OOHCA). For this study, CCC consists of a series of three cycles of continuous chest compressions without pauses for ventilation followed by rhythm analysis or until restoration of spontaneous circulation (ROSC), whichever occurs first. ICC consists of series of three cycles of standard CPR each cycle comprised of chest compressions with interposed ventilations at a compression:ventilation ratio of 30:2 (per AHA guidelines) followed by rhythm analysis or until ROSC, whichever occurs first. In either patient group, the duration of manual CPR before the first rhythm analysis will be 30 seconds or 120 seconds. This treatment period will be followed by two cycles of compressions then rhythm analysis (i.e. each of approximately 2 minutes duration) in either group. Other aims of the trial are to compare survival to discharge among patients grouped by first-recorded rhythm or other a priori subgroups, as well as to compare neurological status at discharge, mechanistic outcomes or adverse events between control and intervention groups.
Investigators
Susanne May
Principal Investigator
University of Washington
Eligibility Criteria
Inclusion Criteria
- •Age 18 years or more (or local age of consent);
- •Initial fire/Emergency Medical Services (EMS) chest compressions provided by Resuscitation Outcomes Consortium (ROC) study participating agency dispatched to the scene;
- •Lack of the exclusion criteria below
Exclusion Criteria
- •EMS witnessed arrest;
- •Written do not attempt resuscitation (DNAR) orders;
- •Obvious primary asphyxia or respiratory cause of arrest (drowning, strangulation, hanging)
- •Advanced airway placed prior to ROC EMS arrival, or pre-existing tracheostomy
- •Traumatic cause (blunt, penetrating, burn) of arrest;
- •Known prisoners;
- •Known pregnancy;
- •Uncontrolled bleeding or exsanguination
- •Mechanical compression device used during study-assigned compression cycles
Outcomes
Primary Outcomes
Number of Participants Who Survive From the Time of Cardiac Arrest to Hospital Discharge
Time Frame: Patients will be followed from the time of the cardiac arrest until death or hospital discharge, whichever occurs first.
Patients may die in the field (outside of the hospital at the time of the cardiac arrest), at the emergency room, in the hospital, or they are discharged alive from the hospital.
Secondary Outcomes
- Percentage of Participants Scoring at or Below a 3 on the MRS Scale(Patients will be followed from the time of the cardiac arrest until death or hospital discharge, whichever occurs first.)