■在英国,院外心脏骤停(OHCA)患者中只有不到十分之一的人能够出院。对于院前团队,尽管有高级生命支持(ALS),但仍在难治性OHCA中的患者改善预后;增加自发循环恢复可能性的新策略,同时保持脑循环,应该调查。复苏的血管内球囊闭塞主动脉(REBOA)已被证明可以改善心肺复苏期间的冠状动脉和脑灌注。早期,院前开始使用REBOA可能会改善对标准ALS无反应的患者的结局.然而,有重要的临床,技术,以及在OHCA中快速提供院前REBOA的后勤挑战;在英国城乡环境中提供这种干预的可行性尚未评估。
■院外心脏骤停(ERICA-ARREST)主动脉的紧急复苏腔内球囊闭塞是一项前瞻性研究,单臂,介入可行性研究。该试验将招募20名非创伤性OHCA成年患者。主要目的是评估在英国院前环境中尽管有标准ALS但仍留在OHCA的患者中进行I区(腹腔上)主动脉闭塞的可行性。试验的次要目标是描述对主动脉闭塞的血流动力学和生理反应;报告关键时间间隔;并记录在此情况下进行REBOA时的不良事件。
■使用压缩的地理,和有针对性的调度,除了完善的股动脉接入计划,ERICA-ARREST研究将评估在英国城乡混合的OHCA中部署REBOA的可行性。试用登记。ClinicalTrials.gov(NCT06071910),注册日期2023年10月10日,https://classic。clinicaltrials.gov/ct2/show/NCT06071910.
UNASSIGNED: Fewer than one in ten out-of-hospital cardiac arrest (OHCA) patients survive to hospital discharge in the UK. For prehospital teams to improve outcomes in patients who remain in refractory OHCA despite advanced life support (ALS); novel strategies that increase the likelihood of return of spontaneous circulation, whilst preserving cerebral circulation, should be investigated. Resuscitative Endovascular Balloon Occlusion of the Aorta (
REBOA) has been shown to improve coronary and cerebral perfusion during cardiopulmonary resuscitation. Early, prehospital initiation of
REBOA may improve outcomes in patients who do not respond to standard ALS. However, there are significant clinical, technical, and logistical challenges with rapidly delivering prehospital
REBOA in OHCA; and the feasibility of delivering this intervention in the UK urban-rural setting has not been evaluated.
UNASSIGNED: The Emergency Resuscitative Endovascular Balloon Occlusion of the Aorta in Out-of-Hospital Cardiac Arrest (ERICA-ARREST) study is a prospective, single-arm, interventional feasibility study. The trial will enrol 20 adult patients with non-traumatic OHCA. The primary objective is to assess the feasibility of performing Zone I (supra-coeliac) aortic occlusion in patients who remain in OHCA despite standard ALS in the UK prehospital setting. The trial\'s secondary objectives are to describe the hemodynamic and physiological responses to aortic occlusion; to report key time intervals; and to document adverse events when performing
REBOA in this context.
UNASSIGNED: Using compressed geography, and targeted dispatch, alongside a well-established femoral arterial access programme, the ERICA-ARREST study will assess the feasibility of deploying
REBOA in OHCA in a mixed UK urban and rural setting.Trial registration.ClinicalTrials.gov (NCT06071910), registration date October 10, 2023, https://classic.clinicaltrials.gov/ct2/show/NCT06071910.