Clinical Trials Logo

Clinical Trial Summary

Neither the international nor the interregional variation in survival following OHCA is fully understood, but may rely on multiple factors such as: organization of the Emergency Medical Service (EMS) system bystander cardiopulmonary resuscitation (CPR), the use of Automatic External Defibrillators (AED's), response time, and which subgroups are included as the denominator, (i.e. obvious dead, withholding of resuscitation). Variation in denominators provide an obstacle when comparing outcome between different EMS-systems. Studies have found that Utstein factors explained half of the variation in survival to hospital discharge among different EMS agencies highlighting the importance of further research. Due to the high mortality rate of OHCA, the decision of withholding or withdrawing resuscitative efforts must be made frequently. We find that a description of the differences in initiation and termination of resuscitation of adult patients (>18 years of age), suffering from non-traumatic OHCA could add an important perspective on the impact of differences in EMS systems across the World regarding the outcome following OHCA.


Clinical Trial Description

Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in the World. Substantial international differences in survival to hospital discharge has been reported; ranging from 3.1% to 20.4% worldwide, 0% to 18% in Europe, 0,5% to 8,5% in Asia, 9% to 17% in Australia and New Zealand and from 1.1% to 8.4% in North America. Regional differences of up to a fivefold increase in survival have also been reported in multiple settings and geographic locations. Neither the international nor the interregional variation is fully understood, but may rely on multiple factors such as: organization of the Emergency Medical Service (EMS) system bystander cardiopulmonary resuscitation (CPR), the use of Automatic External Defibrillators (AED's), response time, and which subgroups are included as the denominator, (i.e. obvious dead, withholding of resuscitation). Variation in denominators provide an obstacle when comparing outcome between different EMS-systems. Studies have found that Utstein factors explained half of the variation in survival to hospital discharge among different EMS agencies highlighting the importance of further research. Due to the high mortality rate of OHCA, the decision of withholding or withdrawing resuscitative efforts must be made frequently. The European Resuscitation Council (ERC) stated in their 2021 guidelines that: 1. "Systems should implement criteria for the withholding and termination of CPR out-of-hospital cardiac arrest (OHCA), taking into consideration the specific local legal, organizational, and cultural context." 2. "Systems should define criteria for the withholding and termination of CPR, and ensure criteria are validated locally." 3. "Systems should implement criteria for early transport to hospital in cases of OHCA, taking into account the local context, if there are no criteria for withholding/terminating CPR". To validate Termination of Resuscitation rules locally could be challenging both ethically and epidemiologically. This would require a prospective study with a transportation rate of 100%, which could put an immense amount of pressure on the limited sources of the EMS system, and moreover providing sufficient power in the study could be difficult. We find that a description of the differences in initiation and termination of resuscitation of adult patients (>18 years of age), suffering from non-traumatic OHCA could add an important perspective on the impact of differences in EMS systems across the World regarding the outcome following OHCA. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT05029180
Study type Observational
Source University of Southern Denmark
Contact
Status Not yet recruiting
Phase
Start date May 16, 2022
Completion date September 1, 2022

See also
  Status Clinical Trial Phase
Recruiting NCT05434910 - Blood Pressure and Cerebral Blood Flow After Cardiac Arrest N/A
Active, not recruiting NCT03700125 - Pre-hospital ECMO in Advanced Resuscitation in Patients With Refractory Cardiac Arrest. ( SUB30 ) N/A
Completed NCT02527694 - CPR Quality Between Flexible Stretcher and Standard Stretcher in OHCA N/A
Completed NCT02899507 - Prophylactic Antibiotics in Comatose Survivors of Out-of-hospital Cardiac Arrest Phase 4
Recruiting NCT02184468 - Survival Study After Out-of-hospital Cardiac Arrest N/A
Completed NCT04085692 - Dispatcher-Assisted CPR: Low-Dose, High-Frequency Simulation-Based Training N/A
Recruiting NCT05029167 - REstrictive Versus LIberal Oxygen Strategy and Its Effect on Pulmonary Hypertension After Out-of-hospital Cardiac Arrest (RELIEPH-study) N/A
Completed NCT04080986 - DOuble SEquential External Defibrillation for Refractory VF N/A
Completed NCT04058925 - Tissue Oxygenation During Cardiopulmonary Resuscitation as a Predictor of Return of Spontaneous Circulation
Enrolling by invitation NCT05113706 - Does Bystanders Emotional State Influence Dispatcher-assisted Cardiopulmonary?Resuscitation
Completed NCT04219306 - Machine Learning Assisted Recognition of Out-of-Hospital Cardiac Arrest During Emergency Calls. N/A
Completed NCT03881865 - P25/30 SSEPs and Neurological Prognosis After Cardiac Arrest
Recruiting NCT04993716 - Epidemiological Study on the Management of Out-of-hospital Cardiac Arrest Survivors in Champagne ArDEnnes
Completed NCT05062785 - Dose-Finding Study of Intranasal Insulin in Healthy Participants Insulin in Healthy Participants Phase 1
Recruiting NCT06122337 - Systemic Evaluation of the Etiologies of Young Adults With Non-traumatic Out-of-hospital Cardiac Arrest
Not yet recruiting NCT04584463 - Factors Associated With CPC 1-2 in 110 Patients Admitted in French ICU for a Myocardial Infarction Complicated by an OHCA.
Recruiting NCT03355885 - Early-onset Pneumonia After Out-of-hospital Cardiac Arrest N/A
Recruiting NCT05132387 - Wroclaw Out-Of-Hospital Cardiac Arrest Registry
Not yet recruiting NCT06046339 - Left Ventricular Ejection Fraction in Cardiac Arrest Survivors Treated With Extracorporeal Cardiopulmonary Resuscitation
Not yet recruiting NCT05969028 - First Responder Airway & Compression Rate Trial N/A