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Cardiac Arrest Bundle of cARE Trial (CABARET): a feasibility randomised controlled study of a bundle of care

James O M Plumb1,2,3, James Raitt3,4, Andrew Claxton5

  • 1Hampshire and Isle of Wight Air Ambulance, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Resuscitation Plus
|May 13, 2026
PubMed

Insights

The CABARET trial found that a head-up position and impedance threshold device (ITD) cardiopulmonary resuscitation (CPR) bundle is feasible for out-of-hospital cardiac arrest (OHCA) patients. This approach can be delivered effectively, supporting future large-scale trials for improved OHCA outcomes.

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Resuscitation Science

Background:

  • Out-of-hospital cardiac arrest (OHCA) survival rates remain critically low.
  • Enhancing cerebral perfusion during cardiopulmonary resuscitation (CPR) is crucial for neurological recovery.
  • Bundled interventions are being explored to improve CPR effectiveness in OHCA.

Purpose of the Study:

  • To assess the feasibility of delivering a novel resuscitation bundle in OHCA patients.
  • To evaluate the safety and adherence of a head-up position CPR (HUP-CPR) and impedance threshold device (ITD) bundle.
  • To gather data for designing a definitive randomized controlled trial (RCT) for OHCA.

Main Methods:

  • The CABARET trial was a multicenter randomized feasibility study.
  • Patients received either standard advanced life support or a bundle of HUP-CPR, mechanical chest compressions, and ITD.
  • Feasibility outcomes included recruitment, randomization, adherence, training, and data completeness.

Main Results:

  • Successful recruitment of all 32 planned patients (9.5% of eligible OHCA cases).
  • High protocol adherence and training efficacy were observed across sites.
  • Data completeness was generally good, with minor issues in CO2 measurements.

Conclusions:

  • The CABARET feasibility trial successfully demonstrated the deliverability of a HUP-CPR and ITD bundle during OHCA.
  • The findings provide a strong basis for conducting a definitive RCT to evaluate this resuscitation strategy.
  • The bundle was delivered with high fidelity and did not interfere with standard resuscitation care.
Abstract

Keywords:
Head up CPR (HUP-CPR)Impedance threshold device (ITD)Neuroprotective CPR bundle

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