None listed
Conditions
Brief summary
The CHEER 3 Trial is a treatment strategy aimed at providing hope for patients who are otherwise very likely to die. In patients who suffer cardiac arrest, a range of interventions such as CPR, defibrillation and injection of drugs are provided at the scene by paramedics to attempt to restart the heart. If paramedics are unsuccessful, there is very little hope of recovery and the patient is usually declared deceased at scene. Transport to hospital with CPR may be attempted but previous research indicates this is usually unsuccessful due to the time taken to arrive at hospital for further treatments. This trial will evaluate an alternative approach involving doctors from The Alfred Hospital being transported to the scene and placing the patient on a heart-lung machine called ECMO. Once stabilised on ECMO, the patient will then be taken to the Alfred Hospital for further investigations and treatment.
Interventions
All patients enrolled in the trial will undergo CPR at the scene prior to and after enrolment into the trial until ECMO is functioning. All enrolled patients will have ECMO attempted and if successful, these patients will then be transported to hospital for further management including transfer to the catheterisation lab if appropriate. Both pre-hospital ambulance care records and Alfred Hospital records will be reviewed by investigators for compliance, to identify any problems and for data coll
All patients enrolled in the trial will undergo CPR at the scene prior to and after enrolment into the trial until ECMO is functioning. All enrolled patients will have ECMO attempted and if successful, these patients will then be transported to hospital for further management including transfer to the catheterisation lab if appropriate. Both pre-hospital ambulance care records and Alfred Hospital records will be reviewed by investigators for compliance, to identify any problems and for data collection. Treatment: Device - Extracorporeal Membrane Oxygenation (ECMO) Insertion of peripheral veno-arterial ECMO at scene of cardiac arrest by ECMO team including two Intensive Care Consultants Treatment: Cardiopulmonary Resuscitation (CPR) CPR will be given to the patient until ECMO has been implemented. Treatment: Early Reperfusion Once the patient has been transported to hospital, they will be taken directly to the Catheterisation Lab if appropriate.
Sponsors
Ambulance Victoria
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Age 18 to 70 years Witnessed cardiac arrest (bystander or paramedic) Time from arrest to commence chest compressions of less than 5 minutes Duration of cardiac arrest between 20 and 45 minutes Initial cardiac rhythm of Ventricular Fibrillation/pulseless Ventricular Tachycardia/Pulseless Electrical Activity In cardiac arrest on arrival of ECMO team
Exclusion criteria
Traumatic arrest including hanging Known to have significant life-limiting co-morbidities (eg COPD/cirrhosis/dementia) or terminal illness
Outcome results
None listed