The Application of Positive End-Expiratory Pressure in Out-of-Hospital Cardiac Arrest: The Lazarus-PEEP Trial.

Launched by UNIVERSITY HOSPITAL, GHENT · Apr 14, 2025

Keywords

ClinConnect Summary

The Lazarus-PEEP Trial is a clinical study aimed at finding out if a technique called Positive End-Expiratory Pressure (PEEP) can improve the chances of survival for adults who experience cardiac arrest outside of a hospital. During cardiac arrest, the heart stops beating, and CPR is performed to try to restart it. This trial will compare standard CPR to CPR that includes PEEP, which helps keep the airways open and may improve oxygen delivery during resuscitation. The researchers want to see if using PEEP leads to better heart recovery and improved brain function after a cardiac arrest.

To take part in this trial, participants must be adults aged 18 or older who have had a non-traumatic cardiac arrest and are receiving CPR from a specialized emergency medical team. Participants will be randomly assigned to one of two groups—one that receives CPR with PEEP and one that receives standard CPR. The study will also monitor for any potential side effects from using PEEP, like increased pressure in the chest. This research aims to provide valuable insights that could change how CPR is performed in the future to help save more lives.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Age: Adults aged 18 years and older.
• • 2. Type of Cardiac Arrest: Patients who have experienced a non-traumatic out-of-hospital cardiac arrest.
• • 3. CPR Administration: Patients receiving cardiopulmonary resuscitation from an advanced life support (ALS) team.
• • 4. Intubation and Ventilation: Patients who are intubated and ventilated during resuscitation efforts.
• Exclusion Criteria:
• • 1. Cardiac arrest in patient younger than 18 years of age.
• • 2. Traumatic cardiac arrest, including drowning, penetrating or blunt injury, and burns.
• • 3. Immediate Return of Spontaneous Circulation (ROSC): Patients who achieve ROSC before intubation and initiation of intubation.
• • 4. Pregnancy.
• • 5. Mechanical ventilation during arrest: patients already receiving mechanical ventilation at the moment of cardiac arrest, due to reasons other than their arrest, will be excluded.
• • 6. Do Not Resuscitate (DNR) Orders: Patients with existing DNR orders or any advanced directive indicating that CPR should not be performed.
• • 7. Failure to intubate: if intubation is unsuccessful, ventilation by any means (MBV, SGA) should take priority over the study protocol, and the patient is excluded.
• • 8. Enrolment in Other Studies: Patients currently enrolled in another interventional clinical trial that could interfere with the outcomes of this study.