Cardiac Arrest Bundle of cARE Trial (CABARET) survey of current UK neuroprotective CPR practice

Area of Science:

• Emergency medicine
• Resuscitation science
• Neurocritical care

Background:

• Out-of-hospital cardiac arrest (OOHCA) in the UK has low survival rates.
• Animal studies suggest neuroprotective strategies, including bundled CPR approaches, may improve cerebral blood flow.
• Current UK pre-hospital critical care services show limited adoption of these advanced interventions.

Purpose of the Study:

• To investigate the feasibility of implementing a bundled neuroprotective CPR approach in UK pre-hospital settings.
• To address the evidence gap in advanced resuscitation techniques for OOHCA.
• To evaluate the potential of combining Head Up Position (HUP), Active Compression/Decompression (ACD) CPR, and the Impedance Threshold Device (ITD).

Main Methods:

• A survey of 27 UK pre-hospital critical care services was conducted.
• The survey assessed the current utilization of HUP, ACD CPR, and ITD, individually and as a bundle.
• A pilot study is being initiated to assess the feasibility of the CPR bundle.

Main Results:

• None of the surveyed UK pre-hospital critical care services are widely using the HUP, ACD CPR, or ITD interventions, either alone or as a bundle.
• Significant variation in the adoption of these neuroprotective CPR components exists.

Conclusions:

• There is a substantial gap between the potential benefits suggested by animal studies and the current clinical practice of OOHCA resuscitation in the UK.
• The planned pilot study is crucial for determining the feasibility of implementing this CPR bundle in real-world settings.
• Further research is needed to optimize and integrate neuroprotective CPR strategies to improve patient outcomes.