Early Initiation of Extracorporeal Life Support in Refractory OHCA (INCEPTION)
Cardiac Arrest, Out-Of-Hospital Cardiac Arrest, Sudden Cardiac Death
About this trial
This is an interventional treatment trial for Cardiac Arrest focused on measuring ECPR, Extracorporeal CardioPulmonary Resuscitation, OHCA, Out-of-Hospital Cardiac Arrest, CPR, CardioPulmonary Resuscitation, ECMO, ExtraCorporeal Membrane Oxygenation, Refractory Cardiac Arrest
Eligibility Criteria
Inclusion Criteria:
- ≥18 - ≤70 years
- Witnessed OHCA (by bystanders)
- Initial rhythm of VF/VT or AED administered
- Bystander BLS
Exclusion Criteria:
- ROSC within 15 minutes of conventional CPR with sustained hemodynamic recovery
- Terminal heart failure (NYHA III or IV)
- Severe pulmonary disease (COPD GIII of GIV)
- Disseminated oncological disease
- Obvious or suspected pregnancy
- Bilateral femoral bypass surgery
- Known contraindications for ECPR
- Known pre-arrest CPC-score of 3 or 4
- Known limitations in therapy or a Do Not Resuscitate-order
- Multitrauma (Injury Severity Score >15)
- Expected time-to-start cannulation > 60 minutes
Sites / Locations
- Maastricht UMC
- Catharina Ziekenhuis
- Academisch Medisch Centrum
- Isala Klinieken
- St. Antonius Hospital
- Leids Universitair Medisch Centrum
- Onze Lieve Vrouwen Gasthuis
- HagaZiekenhuis
- Erasmus MC
- Universitair Medisch Centrum Utrecht
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
CCPR protocol
ECPR protocol
Preclinical Cardiopulmonary resuscitation (CPR) by emergency medical services (EMS) and rapid transport to the emergency department with ongoing mechanical CPR and advanced cardiac life support (ACLS). Clinical Upon the patient's arrival, the standard of care (CCPR) will be continued according to ERC guidelines. No special preparations for the trial are needed before the patient's arrival.
Preclinical Cardiopulmonary resuscitation (CPR) by emergency medical services (EMS) and transport to the emergency department with ongoing mechanical CPR and advanced cardiac life support (ACLS). Clinical The ECPR team is mobilized while the patient is transported to the hospital. Initiation of extracorporeal cardiopulmonary resuscitation (ECPR). Time from arrest to start of cannulation is < 60 minutes.