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CHEER4TTE is a target trial emulation, designed to simulate a randomised controlled trial by utilising data from pre-existing data sources. The aim is to determine whether prehospital ECPR for refractory out-of-hospital cardiac arrest improves the rate of survival to hospital discharge when compared to conventional cardiac arrest care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Prehospital Extracorporeal Cardiopulmonary Resuscitation (ECPR) Strategy | Patients with refractory OHCA treated with scene-based, pre-hospital ECPR (Intervention) will be identified within two studies testing feasibility of prehospital ECPR for refractory OHCA in the metropolitan regions of Melbourne and Sydney. All intra-arrest and post-arrest care follow guidelines based on the Australian and New Zealand Council of Resuscitation recommendations supplemented by the Victorian ECMO Service (VECMOS) guidelines within Victoria and Agency for Clinical Innovation ECMO Clinical Practice Guidelines in NSW. |
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| Conventional Cardiac Arrest Strategy | Patients with refractory OHCA treated with conventional cardiac arrest strategy (standard care) will be identified within NSW and Victorian Ambulance OHCA Registries. All intra-arrest and post-arrest care for patients in this group follow guidelines based on the Australian and New Zealand Council of Resuscitation recommendations. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Extracorporeal cardiopulmonary resuscitation | Other | The Intervention being evaluated is the initiation of extracorporeal cardiopulmonary resuscitation (ECPR) at the scene, in addition to conventional cardiac arrest care. |
| Measure | Description | Time Frame |
|---|---|---|
| Survival to hospital discharge | From meeting full eligibility criteria until the date/time of death or hospital discharge, assessed up to 180 days |
| Measure | Description | Time Frame |
|---|---|---|
| Low flow time | time from onset of arrest to time of ECPR flow, or time of death | |
| ICU length of stay | From the date/time of ICU admission until the date/time of ICU discharge/death, assessed up to 180 days |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients with refractory out-of-hospital cardiac arrest in the metropolitan regions of Sydney and Melbourne.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Monash University | Melbourne | Victoria | Australia |
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| ID | Term |
|---|---|
| D058687 | Out-of-Hospital Cardiac Arrest |
| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| Mechanical ventilation days | From date/time of mechanical ventilation commencement until date/time of liberation from mechanical ventilation assessed up to 180 days |
| ECMO complications | From the date/time of commencement of ECMO support until 1 week following the date/time of cessation of ECMO support |
| Rates of organ and tissue donation in non-survivors | In the 48hours following date/time of death |