On Scene ECPR in Ostrava

Официальное название

The Effectiveness of ECPR on the Scene and in Hospital for Out-of-hospital Cardi-ac Arrest (OHCA) in the Moravian-Silesian Region.

Обзор

On-scene extracorporeal pulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) seems to speed up the start of extracorporeal membrane oxygenation (ECMO) and shorten low flow during cardiopulmonary resuscitation (CPR) in case of refractory cardiac arrest. The primary goal is to verify the benefit of on-scene ECPR in terms of shortening the collapse-to-ECMO interval. The secondary goal is to compare outcomes in the on-scene ECPR group with hospital cannulation.

Подробное описание

ECPR is a life-saving method for a selected group of patients who are refractory to standard resuscitation procedures. With the appropriate use of ECPR, it is possible to achieve a significant improvement in survival with good neurological outcomes even in patients who would otherwise die. The ECMO Centre Ostrava has been providing ECPR for OHCA since 2022 with cannulation in the hospital after prior transport from the scene under continuous resuscitation. A good neurological outcome is achieved in approximately 29% of patients, even though the collapse-ECMO interval is around 75 minutes. Shortening this interval, which is associated with improved outcomes, is possible by using a mobile team that per-forms cannulation directly on scene. Mobile ECPR will be carried out in cooperation with the Ostrava University Hospital and the Moravian-Silesian Region Emergency Medical Service. The primary objective is to verify the benefit of on-scene ECPR in terms of shortening the collapse-ECMO interval. The secondary objective is to compare the outcome in the on-scene ECPR group with hospital cannulation.

Вмешательства

• Процедура Prehospital ECMO cannulation on scene of cardiac arrest
  ECPR (Extracorporeal Cardiopulmonary Resuscitation) is a critical, advanced resuscitation technique using Veno-arterial Extracorporeal Membrane Oxygenation for patients in cardiac arrest where conventional CPR fails, functioning as a bridge to restore circulation and oxygenation by pumping and oxygenating blood outside the body before returning it.
• Процедура Transfer with ongoing mechanical chest compression to hospital followed by hospital ECMO cannulation
  ECPR (Extracorporeal Cardiopulmonary Resuscitation) is a critical, advanced resuscitation technique using Veno-arterial Extracorporeal Membrane Oxygenation for patients in cardiac arrest where conventional CPR fails, functioning as a bridge to restore circulation and oxygenation by pumping and oxygenating blood outside the body before returning it.

Первичные конечные точки

• Hospital survival [Срок оценки: 30 days after the cardiac arrest]
• ICU stay [Срок оценки: Through the ICU stay, on average 12 days]
• Neurologic outcomes [Срок оценки: 30 days after the cardiac arrest]

Вторичные конечные точки (4)

• Collapse to ECMO interval [Срок оценки: One hour]
• Collapse to ECMO interval [Срок оценки: From the collapse (cardiac arrest) to ECMO initiation]
• Long-term outcome - Survival [Срок оценки: 6 months after the collapse]
• Long-term outcome - Quality of Life [Срок оценки: 6 months after the collapse]

Критерии участия

Критерии включения

• Presumed cardiac aetiology of the cardiac arrest
• Witnessed collapse
• Bystander CPR
• Estimated age ≤ 70 years
• Body weight ≥15 Kg

Критерии исключения

• Known terminal malignant disease
• Known terminal chronic disease

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Нерандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Чехия · 2 центра

• Emergency Medical Services, Moravian-Silesian Region — Ostrava
• University Hospital Ostrava — Ostrava

Идентификаторы

NCT: NCT07374289 · FNO-KARIM-On-Scene-ECPR

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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