Improving Care After Cardiac Arrest by Informing Surrogate Decision Makers - Extension

通过通知代理决策者来改善心脏骤停后的护理 - 扩展

• 批准号: 10406548
• 负责人: Sarah M Perman
• 金额: $ 6.74万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-18 至 2022-03-09
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10406548
• 关键词: Adherence; Caring; Colorado; Coma; Comprehension; Critical Care; Decision Making; Development; Family; Future; Guideline Adherence; Guidelines; Heart Arrest; Hospitals; Hour; International; Intervention; K-Series Research Career Programs; Knowledge; Life; Outcome; Patients; Pragmatic clinical trial; Research; Research Personnel; Research Proposals; Resuscitation; Survivors; Testing; Time; Uncertainty; Universities; Withdrawal; acceptability and feasibility; coronavirus disease; design; evidence based guidelines; improved; improved outcome; life-sustaining therapy; neurological recovery; novel; novel strategies; out-of-hospital cardiac arrest; pilot trial; prognostic; surrogate decision maker; tool

PROJECT SUMMARY – Improving care after cardiac arrest by informing surrogate decision makers Survival and neurological recovery after cardiac arrest are highly variable, driven in part by inconsistent hospital care following successful resuscitation. Significant variability in delivery of evidence based, guideline concordant care has been associated with differences in overall outcome from cardiac arrest. When guidelines are followed, survival with good neurologic recovery is improved. However, adherence to guidelines regarding delayed decision to withdraw life support has been highly variable across US hospitals. Reasons attributed to early withdrawal of life sustaining therapy include poor knowledge of national and international guidelines, requests from family for early outcome predications, and incomplete family comprehension of critical care. In order to encourage utilization of guideline concordant delayed neuro-prognostication and concomitant withdrawal of life-sustaining therapy (>72 hours after resuscitation) we propose a novel approach; to educate and inform surrogate decision makers on neuro-prognostic uncertainty and guideline concordant care. The research proposed in this career development award COVID extension will pilot test a novel intervention that will encourage improved guideline adherence on neuro-prognostication and delayed WLST as well as to support the continued development of Dr. Sarah Perman, an early investigator committed to improving outcomes from out-of-hospital cardiac arrest. In this extension, we will continue a pilot trial of the Tool to EMPOwer (TEMPO) Surrogate Decision Makers of comatose survivors of cardiac arrest at the University of Colorado Hospital. This pilot is intended to determine feasibility and acceptability of the tool as well as knowledge transferred regarding post-cardiac arrest care. We intend to utilize the pilot trial to prepare for widespread implementation of TEMPO. The results of the pilot trial will further inform the design of a multi- center pragmatic clinical trial to implement the educational tool in order to encourage guideline concordant post-cardiac arrest care including delayed neuro-prognostication and delayed withdrawal of life-sustaining therapy. Overall, we hypothesize that informing surrogate decision makers on guideline concordant care, will result in delayed decisions to withdraw life-sustaining therapy and allow the post-arrest patient adequate timing for appropriate neuro-prognostication and awakening, thus improving outcomes from out-of-hospital cardiac arrest. This will be the subject of a future independent research proposal by the applicant.

项目总结：通过告知代理决策者来改善心脏骤停后的护理

项目成果

EAST Multicenter Trial on targeted temperature management for hanging-induced cardiac arrest.

• DOI: 10.1097/ta.0000000000001945
• 发表时间: 2018-07
• 期刊: The journal of trauma and acute care surgery
• 作者: Hsu CH;Haac BE;Drake M;Bernard AC;Aiolfi A;Inaba K;Hinson HE;Agarwal C;Galante J;Tibbits EM;Johnson NJ;Carlbom D;Mirhoseini MF;Patel MB;OʼBosky KR;Chan C;Udekwu PO;Farrell M;Wild JL;Young KA;Cullinane DC;Gojmerac DJ;Weissman A;Callaway C;Perman SM;Guerrero M;Aisiku IP;Seethala RR;Co IN;Madhok DY;Darger B;Kim DY;Spence L;Scalea TM;Stein DM
• 通讯作者: Stein DM

Overcoming Fears to Save Lives: COVID-19 and the Threat to Bystander CPR in Out-of-Hospital Cardiac Arrest.

• DOI: 10.1161/circulationaha.120.048909
• 发表时间: 2020-09-29
• 期刊: Circulation
• 影响因子: 37.8
• 作者: Perman SM

Physician decision processes in post-cardiac arrest care: Can we describe how we decide?

心脏骤停后护理中的医生决策过程：我们能描述一下我们是如何决策的吗？

• DOI: 10.1016/j.resuscitation.2022.02.013
• 发表时间: 2022
• 期刊: Resuscitation
• 影响因子: 6.5
• 作者: Perman,SarahM

Impact of the COVID-19 pandemic on cardiac arrest systems of care.

• DOI: 10.1097/mcc.0000000000000817
• 发表时间: 2021-06-01
• 期刊: Current opinion in critical care
• 影响因子: 3.3
• 作者: Kovach CP;Perman SM
• 通讯作者: Perman SM

Hispanic/Latino-Serving Hospitals Provide Less Targeted Temperature Management Following Out-of-Hospital Cardiac Arrest.

• DOI: 10.1161/jaha.121.023934
• 发表时间: 2021-12-21
• 期刊: JOURNAL OF THE AMERICAN HEART ASSOCIATION
• 影响因子: 5.4
• 作者: Morris, Nicholas A.;Mazzeffi, Michael;McArdle, Patrick;May, Teresa L.;Waldrop, Greer;Perman, Sarah M.;Burke, James F.;Bradley, Steven M.;Agarwal, Sachin;Figueroa, Jose F.;Badjatia, Neeraj
• 通讯作者: Badjatia, Neeraj