Effect of resuscitative endovascular balloon occlusion of the aorta in nontraumatic out-of-hospital cardiac arrest: a...

Area of Science:

• Cardiovascular Medicine
• Emergency Medicine
• Critical Care Medicine

Background:

• Out-of-hospital cardiac arrest (OHCA) is a major global health concern with poor survival and neurological outcomes.
• High-quality chest compressions are crucial for optimal coronary perfusion pressure (CPP), but achieving adequate CPP during resuscitation is challenging.
• Resuscitative endovascular balloon occlusion of the aorta (REBOA) shows promise in improving CPP for nontraumatic OHCA based on preliminary studies.

Purpose of the Study:

• To evaluate the efficacy of REBOA as an adjunct to CPR in patients with nontraumatic OHCA.
• To compare the clinical outcomes of REBOA-CPR versus conventional CPR in OHCA resuscitation.
• To provide evidence for optimizing treatment strategies in OHCA management.

Main Methods:

• A parallel-group, randomized, controlled, multinational trial involving two urban academic tertiary hospitals in Korea and Taiwan.
• Enrollment of patients aged 20-80 years presenting with witnessed OHCA, with informed consent from legal representatives.
• Random assignment to either REBOA-CPR (REBOA plus ACLS) or conventional CPR (ACLS alone based on 2020 AHA guidelines).

Main Results:

• Primary outcome: Return of spontaneous circulation (ROSC).
• Secondary outcomes: Sustained ROSC, survival to admission, survival to discharge, neurological outcome, and hemodynamic changes.
• The study is registered on ClinicalTrials.gov (NCT06031623) and commenced on September 9, 2023.

Conclusions:

• The trial is expected to provide critical evidence on the effectiveness of REBOA in enhancing CPP during OHCA resuscitation.
• Results will determine if REBOA improves clinical outcomes and treatment strategies for nontraumatic OHCA.
• The study aims to offer valuable insights for advancing critical care in OHCA management.