Pre-hospital ECMO or Conventional Resuscitation for Refractory Cardiac Arrest

Launched by AUSTRALIAN AND NEW ZEALAND INTENSIVE CARE RESEARCH CENTRE · Dec 11, 2023

Keywords

ClinConnect Summary

This clinical trial is studying a new approach to treating patients who experience a cardiac arrest outside of the hospital, specifically focusing on those who do not respond to standard resuscitation efforts. The trial will compare two methods: one group of patients will receive a special type of advanced life support called Extracorporeal Cardiopulmonary Resuscitation (ECPR) before reaching the hospital, while another group will receive the usual care. Researchers aim to see how many patients can be successfully treated with each method.

To be eligible for this study, participants need to be adults aged 18 to 70 who have experienced a witnessed cardiac arrest and received CPR from bystanders. They should have been without a heartbeat for more than 20 minutes but less than 45 minutes, and their heart rhythm during the event should be one of several specific types. It’s important to note that individuals with certain severe health conditions or those who have an advance directive stating they do not wish to be resuscitated will not be included. If a participant is accepted into the trial, they will receive either the new treatment or standard care during the critical time before they arrive at the hospital.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult patients 18-70 years old
• • Witnessed cardiac arrest
• • Bystander CPR
• • Refractory cardiac arrest (\>20 mins, but \<45 mins)
• • Initial cardiac rhythm VF, VT or PEA
• • Within hours of PACER service operation (e.g. mon-fri 0800-1700)
• • Within 25 mins of rapid response ambulance (code 1 lights and sirens)
• Exclusion Criteria:
• • Initial cardiac rhythm asystole
• • ROSC with sustained recovery
• • Technically not possible to perform percutaneous cannulation
• * Evidence of/suspectedSignificant end stage disease:
• • Severe disability impairing activities of daily living
• • End-stage organ - cardiac, liver, lung, renal
• • Other life-limiting diseases e.g malignancy, terminal illness
• • Advance health care directive (not for resuscitation)