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Optimal timing of prehospital advanced airway management and epinephrine administration for out-of-hospital cardiac arrest

院外心脏骤停院前高级气道管理和肾上腺素给药的最佳时机

基本信息

批准号：
10580352
负责人：
Masashi Okubo
金额：
$ 11.93万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-12-15 至 2024-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10580352
关键词：
Address Adult Affect American American Heart Association Applications Grants Canada Cardiopulmonary Resuscitation Caring Childhood Clinical Consensus Data Emergency medical service Epinephrine Event Future Goals Grant Guidelines Hospitals Individual International Intervention Intratracheal Intubation Knowledge Life Link Masks Medical Methodology Modeling Outcome Patient-Focused Outcomes Patients Play Population Pre-hospitalization care Principal Investigator Probability Public Health Recommendation Registries Research Resuscitation Risk Role Science Survival Analysis System Techniques Time Time Management United States cardiovascular emergency care systems cohort functional disability functional outcomes functional status improved outcome medication administration mortality out-of-hospital cardiac arrest pediatric patients secondary analysis stomach cardia survival outcome systematic review time use ventilation

项目摘要

ABSTRACT The overarching goal of this R21 Grant proposal is to identify the optimal timing of prehospital advance life support (ALS) interventions for patients with out-of-hospital cardiac arrest (OHCA). The ALS interventions include advanced airway management (AAM: i.e., endotracheal intubation and supraglottic airway placement) and epinephrine administration. OHCA is a major public health problem worldwide, annually affecting over 356,000 Americans with substantially high rates of mortality and functional disability. Emergency medical services (EMS) play an important role for patients with OHCA by providing initial prehospital care, including the ALS interventions in the field. However, the optimal timing of the ALS interventions remains unclear. The 2019 International Liaison Committee on Resuscitation (ILCOR) Summary Statement, International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations identified the optimal time of both AAM and epinephrine administration as key knowledge gaps. We recently found that, for adults with both shockable and nonshockable rhythms, benefit of epinephrine decreased as the administration was delayed, using the Resuscitation Outcomes Consortium (ROC) registry, a large multicenter OHCA registry in the United States and Canada. This R21 Grant project proposes to further expand our research into AAM and pediatric population, analyzing the ROC data. Specific research Aims include identifying the optimal timing of AAM (Aim 1A) and endotracheal intubation (Aim 1B) for adult patients with OHCA, the optimal timing of AAM (Aim 2A) and endotracheal intubation (Aim 2B) for pediatric patients with OHCA, and the optimal timing of epinephrine (Aim3) for pediatric patients with OHCA. This R21 Grant application will provide the Principal Investigator (PI) with protected time to achieve research aims to improve outcomes for patients with OHCA. The results of this R21 proposal will provide crucial information on the timing of ALS interventions for OHCA and inform future national and international resuscitation guidelines.

摘要