OHCA and PARAMEDIC -2

Should adrenaline be used when someone's heart stops?

Cardiac arrest is the term used to describe sudden cessation of heart function. After cardiac arrest occurs, blood stops being circulated to the vital organs and

consciousness is lost within seconds. Unless resuscitation is started promptly death will occur within a few minutes.

Each year about 30,000 people receive resuscitation for an Out-of-Hospital Cardiac Arrest (OHCA) in the United Kingdom (UK). Only one in every twenty people that have a cardiac arrest survive to go home from hospital. Information collected by the Department of Health has shown large differences in the number of people that survive an OHCA depending on where they live. In simple terms people in some parts of the country are twic

e or three times more likely to survive than in other areas.

This project is working with UK Ambulance Services to try and find out the reasons behind such big differences in survival. It has develop a standard way of collecting information about OHCA and for finding out if a resuscitation attempt was successful. The study uses existing information collected by ambulance services during the course of their routine duties. The information will be used to obtain a better understanding of why survival rates vary so widely. It will work out which are the most effective treatments and help ambulance services improve the quality of care for victims of OHCA. Please visit the study's website here.

The PARAMEDIC2 trial is looking at whether adrenaline is helpful or harmful in the treatment of a cardiac arrest that occurs outside a hospital. Answering this question will help to improve the treatment of people who have a cardiac arrest. Please find out more about the study here.

HE: Stavros Petrou, Felix Achana PI: Gavin Perkins

BREATHE

Patients with acute respiratory failure often require invasive ventilation to unload the respiratory muscles and support gas exchange until the cause of the respiratory failure improves. Invasive ventilation used over a prolonged period of time might lead to ventilator associated pneumonia. This, in turn, is associated with increased morbidity and trends towards increased mortality. For these reasons, clinicians caring for patients who need invasive ventilation strive to reduce the duration of invasive ventilation while optimising the chance for successful extubation.

A meta-analysis suggested that use of non-invasive ventilation to wean critically ill adults off invasive ventilation was associated with decreased mortality and other clinical benefits (Burns et al. BMJ, 2009, 338:b1574). The net clinical and cost effectiveness of non-invasive ventilation based weaning compared to other weaning strategies is uncertain.

The Breathe study is a pragmatic, multi-centre randomised controlled trial designed to evaluate the clinical benefits and cost effectiveness of non-invasive weaning. To find out more about the study, please visit the study website.

HE: Stavros Petrou, Mandy Maredza PI: Gavin Perkins