A randomized trial of expedited intra-arrest transfer versus more extended on-scene resuscitation for refractory out of hospital cardiac arrest: Rationale and design of the EVIDENCE trial

被引：5

作者：

Burns, Brian ^{[1
,2
]}

Marschner, Ian ^{[2
,3
]}

Eggins, Renee ^{[2
,3
]}

Buscher, Hergen ^{[4
,5
]}

Morton, Rachael L. ^{[2
]}

Bendall, Jason ^{[1
]}

Keech, Anthony ^{[2
,6
]}

Dennis, Mark ^{[2
,6
,7
]}

机构：

[1] New South Wales Air Ambulance, Sydney, NSW, Australia

[2] Univ Sydney, Fac Med & Hlth, Sydney, Australia

[3] Univ Sydney, NHMRC Clin Trials Ctr, Sydney, NSW, Australia

[4] St Vincents Hosp, Sydney, Australia

[5] Univ New South Wales, Sydney, Australia

[6] Royal Prince Alfred Hosp, Sydney, Australia

[7] Missenden Rd, Darlington, NSW 2006, Australia

来源：

AMERICAN HEART JOURNAL | 2024年 / 267卷

基金：

芬兰科学院;

关键词：

EXTRACORPOREAL CARDIOPULMONARY-RESUSCITATION; PERCUTANEOUS CORONARY INTERVENTION; EARLY REPERFUSION; MULTICENTER; STATEMENT; SURVIVAL; INSIGHTS; OUTCOMES; CPR;

D O I：

10.1016/j.ahj.2023.10.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Refractory Out of Hospital Cardiac Arrest (r-OHCA) is common and the benefit versus harm of intra-arrest transport of patients to hospital is not clear.Objective To assess the rate of survival to hospital discharge in adult patients with r-OHCA, initial rhythm pulseless ventricular tachycardia (VT)/ventricular fibrillation (VF) or Pulseless Electrical Activity (PEA) treated with 1 of 2 locally accepted standards of care:1 expedited transport from scene; or2 ongoing advanced life support (ALS) resuscitation on-scene.Hypothesis We hypothesize that expedited transport from scene in r-OHCA improves survival with favorable neuro-logical status/outcome. Methods/Design Phase III, multi-center, partially blinded, prospective, intention-to-treat, safety and efficacy clinical trial with contemporaneous registry of patient ineligible for the clinical trial. Eligible patients for inclusion are adults with witnessed r-OHCA; estimated age 18 to 70, assumed medical cause with immediate bystander cardiopulmonary resuscitation (CPR); initial rhythm of VF/pulseless VT, or PEA; no return of spontaneous circulation following 3 shocks and/or 15 minutes of professional on-scene resuscitation; with mechanical CPR available. Two hundred patients will be randomized in a 1:1 ratio to either expedited transport from scene or ongoing ALS at the scene of cardiac arrest.Setting Two urban regions in NSW Australia.Outcomes Primar y: sur vival to hospital discharge with cerebral performance category (CPC) 1 or 2. Secondary: safety, survival, prognostic factors, use of ECMO supported CPR and functional assessment at hospital discharge and 4 weeks and 6 months, quality of life, healthcare use and cost-effectiveness.Conclusions The EVIDENCE trial will determine the potential risks and benefits of an expedited transport from scene of cardiac arrest. (Am Heart J 2024;267:22-32.)

引用

页码：22 / 32

页数：11

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