A Randomised Double Blinded Placebo Controlled Trial Of Adrenaline In Cardiac Arrest.
Funder
National Health and Medical Research Council
Funding Amount
$200,500.00
Summary
It is estimated that in excess of 30,000 Australians per year suffer a cardiac arrest, mostly occurring outside of hospital. This sudden and often unpredictable event commonly occurs as a result of acute heart disease, injury, drug overdose and many other illnesses which affect both males and females of all ages. Unfortunately, the survival of those suffering a cardiac arrest remains poor. Best evidence to date suggests overall survival from cardiac arrest to be in the order of about 5%. While t ....It is estimated that in excess of 30,000 Australians per year suffer a cardiac arrest, mostly occurring outside of hospital. This sudden and often unpredictable event commonly occurs as a result of acute heart disease, injury, drug overdose and many other illnesses which affect both males and females of all ages. Unfortunately, the survival of those suffering a cardiac arrest remains poor. Best evidence to date suggests overall survival from cardiac arrest to be in the order of about 5%. While the survival for those suffering cardiac arrest remains poor, the rapid initiation of cardiopulmonary resuscitation (CPR) and defibrillation has been clearly shown to improve outcome. While defibrillation and CPR have been shown to be beneficial, the use of vasoactive drugs such adrenaline has not been proven to improve survival in cardiac arrest. This is despite adrenaline being internationally recommended as first line drug therapy in the advanced life support (ALS) management of cardiac arrest. It is now well acknowledged that clinical trials need to be undertaken to determine the clinical effects of adrenaline when used for cardiac arrest. The purpose of this study is to randomise patients suffering a cardiac arrest to receive either adrenaline (according to standard ALS guidelines) or a placebo. All other care for both groups will be the same and in accordance with current ALS guidelines. In this way we will be able to determine the effects of adrenaline on outcome, particularly survival, following cardiac arrest. The study will run for three years and involve all cardiac arrests attended by the Ambulance Service in Perth.Read moreRead less
A Population Based Linked Data Analysis Of The Prognostic Determinants Of Out Of Hospital Cardiac Arrest
Funder
National Health and Medical Research Council
Funding Amount
$174,000.00
Summary
Heart disease, resulting in a cardiac arrest, is the largest single cause of death for men and women in Australia, accounting alone for almost a quarter of all deaths. Despite the scope of the problem, there is a paucity of objective data about the factors that determine outcomes in the short-term and long-term. This study will capitalise on the unique research potential of the WA Data Linkage Project to combine the WA Cardiac Arrest Register with existing health service data and death records, ....Heart disease, resulting in a cardiac arrest, is the largest single cause of death for men and women in Australia, accounting alone for almost a quarter of all deaths. Despite the scope of the problem, there is a paucity of objective data about the factors that determine outcomes in the short-term and long-term. This study will capitalise on the unique research potential of the WA Data Linkage Project to combine the WA Cardiac Arrest Register with existing health service data and death records, to describe the outcomes of out-of-hospital cardiac arrest in Perth WA. Both morbidity and mortality will be described and compared to patients with similar health conditions, but who do not experience a cardiac arrest. More specifically this study will address questions such as 'what is the effect of age, gender, pre-existing illness and socio-economic status on survival from out-of-hospital cardiac arrest?' and What is the long-term survival and health status for initial survivors of out-of-hospital cardiac arrest?' This project will both identify those factors associated with best outcome as well as identify a profile of persons who are 'at risk' of experiencing a further cardiac arrest. Such information is important for the evaluation of current resuscitative practices as well as providing the basis for future planning initiatives.Read moreRead less
Up to 80% of out of hospital cardiac arrest patients do not receive bystander CPR –often because those at the scene do not have the required skills. Without immediate action the condition is fatal. Through my doctoral research I aim to investigate the best methods for providing a targeted approach of training basic life support to a group at high risk of these events -cardiac patients. I plan to develop and test the feasibility of incorporating this training into cardiac rehabilitation programs.
A Randomised Trial Of Core Cooling Versus Surface Cooling In Comatose Survivors Of Prehospital Cardiac Arrest
Funder
National Health and Medical Research Council
Funding Amount
$309,000.00
Summary
Pre-hospital sudden cardiac arrest (SCA) is a major public health problem that is estimated to cause around one death per thousand adults per year. The aetiology of SCA is usually ischaemic heart disease causing ventricular fibrillation (VF). The current medical response to this condition involves a Chain of Survival, including early call to 000, bystander CPR, early defibrillation and early advanced cardiac life support. Following successful cardiac resuscitation, patients are transported to ho ....Pre-hospital sudden cardiac arrest (SCA) is a major public health problem that is estimated to cause around one death per thousand adults per year. The aetiology of SCA is usually ischaemic heart disease causing ventricular fibrillation (VF). The current medical response to this condition involves a Chain of Survival, including early call to 000, bystander CPR, early defibrillation and early advanced cardiac life support. Following successful cardiac resuscitation, patients are transported to hospital for further care. Despite this approach and recent improvements such as decreased ambulance response times, outcome remains poor and there are very few survivors who make a good recovery. This proposal is for funding to conduct a randomised, controlled trial, which compares two different techniques of induction of hypothermia in patients who are resuscitated from pre-hospital sudden cardiac arrest. Recently available data suggests that the outcome from SCA is significantly improved if moderate hypothermia is used as a treatment of neurological injury. However, the technique of induction of hypothermia requires further research. This study compares core-cooling using large-volume ice-cold intravenous fluid with the current technique of using ice packs for surface cooling, initiated in the field by ambulance paramedics and continued in hospital for a total of 12 hours. This study has the potential to demonstrate a significant improvement in outcome in a common clinical condition, which currently carries a very high mortality rate. This will be the first trial internationally which assess core versus surface cooling initiated pre-hospital, in SCA patients. It is highly likely that with the successful results from this trial that induced hypothermia in SCA patients will become standard care. The use of induced hypothermia could lead to over 500 lives saved per year accross Australia.Read moreRead less
Improving The Outcome Of Critically Ill Patients Through The Generation Of Evidence And Its Translation Into Practice
Funder
National Health and Medical Research Council
Funding Amount
$329,822.00
Summary
This research program will test new approaches to sepsis, traumatic brain injury, kidney protection, nutrition, post-operative care, sedation, cardiac arrest, and mobilisation of acutely ill patients to deliver better outcomes. Experimental research will help understand kidney injury during severe infection and develop new ways of protecting the brain during cardiac arrest. Database investigations will identify successful patterns of treatment and potential new fields of investigations.
Out-of-hospital cardiac arrest is fatal without immediate resuscitation. Paramedic competency in resuscitation has been shown to influence cardiac arrest survival. Through my doctoral research I aim to investigate: how paramedic exposure to cardiac arrest can influence patient survival; the practices emergency medical services currently use to develop and maintain paramedic competency in resuscitation; and the confidence and perceived competency of paramedics responding to cardiac arrests.
Assessment Of Remote Ischemic Conditioning On Post-cardiac Arrest Myocardial Dysfunction By Magnetic Resonance Imaging, Invasive Coronary Hemodynamic Measurements And Markers Of Inflammation
Funder
National Health and Medical Research Council
Funding Amount
$265,881.00
Summary
Cardiac arrest and heart attack continue to cause unacceptably high mortality and morbidity. Even following successful resuscitation many people do not recover due to the inflammation caused by a lack of blood flow. We will investigate remote ischemic conditioning, utilizing a combination of world class imaging with heart MRI, flow monitors directly in heart arteries and markers of inflammation, We aim to determine the impact and recovery to the heart, brain and circulation of this new therapy.