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Evaluating the current breadth of randomized control trials on cardiac arrest: A scoping review

Jake Toy1,2,3,4, Lauren Friend5, Kelsey Wilhelm2,3,4

  • 1Los Angeles County EMS Agency Santa Fe Springs California USA.

Journal of the American College of Emergency Physicians Open
|October 21, 2024
PubMed
Abstract

Insights

Cardiac arrest randomized controlled trials (RCTs) saw no increase from 2015-2022. Research gaps exist in in-hospital and pediatric cardiac arrest studies, despite the significant disease burden.

Area of Science:

  • Cardiology
  • Clinical Research
  • Public Health

Background:

  • Cardiac arrest presents a significant global health challenge.
  • There is a notable lack of robust randomized controlled trials (RCTs) to guide clinical management strategies.
  • Evaluating the landscape of existing RCTs is crucial for identifying research gaps.

Purpose of the Study:

  • To assess the scope and trends of cardiac arrest RCTs published between 2015 and 2022.
  • To identify potential research gaps in the field of cardiac arrest management.

Main Methods:

  • A comprehensive literature search was conducted in October 2023 across MEDLINE, Embase, and Web of Science.
  • Included studies were RCTs published from 2015 to 2022 involving human subjects with non-traumatic cardiac arrest.
  • Descriptive statistics and the Mann Kendall test were used to analyze publication trends and trial characteristics.

Main Results:

  • Eighty-seven RCTs were included, with no significant annual increase in publications observed (p=1.0).
  • Denmark and the United States led in trial contributions. Most trials focused on adult, out-of-hospital cardiac arrest.
  • Interventions included process improvements, drugs, and devices, with similar application in prehospital and ICU settings, and during intra- and post-arrest periods. Survival at ≥28 days was a common primary outcome.

Conclusions:

  • The number of published cardiac arrest RCTs remained stable between 2015 and 2022.
  • Significant research gaps were identified, particularly concerning in-hospital cardiac arrest and pediatric populations.
  • Further research is needed to address these understudied areas in cardiac arrest management.
Keywords:
clinical trials as topicheart arrestout‐of‐hospital cardiac arrestrandom allocation

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