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Issues in Establishing The Refractory Out-Of-Hospital Cardiac Arrest Treated With Mechanical CPR, Hypothermia, ECMO And Early Reperfusion (CHEER) study D Stub 1,2,3 , S Bernard 1,2,4 , V Pellegrino 1 , K Smith 2,4 , Tony Walker 4 , M Stephenson 4 , J Shendylake 1 , L Hockings 1 , S Duffy 1,2,3 , J Shaw 1,2,3 , P Cameron 1,2 , D Smit 1 , D Kaye 1,2,3 1 Alfred Hospital, 2 Monash University, 3 Baker IDI Heart and Diabetes Research Institute, 4 Ambulance Victoria Background: Survival after out-of-hospital cardiac arrest (OHCA) remains poor. There is growing international interest in utilizing extracorporeal membrane oxygenation assisted CPR (ECPR) to improve management of cardiac arrest. We seek to describe our experiences in establishing Australia’s first pilot trial into ECPR and refractory VF OHCA. Methods: The Refractory Out-Of-Hospital Cardiac Arrest Treated With Mechanical CPR, Hypothermia, ECMO And Early Reperfusion (CHEER study) is collaboration between the Alfred Hospital and Ambulance Victoria. In the pre-hospital phase patients with refractory VF arrest within study recruitment hours are placed on the Zoll Auto Pulse, administered 2L of ice-cold saline and transported code-1 to the Alfred Hospital together with standard resuscitation measures. The ECPR team is mobilised to the emergency department, whereby, the femoral artery and vein are percutaneously cannulated for VA-ECMO, and the patient cooled to 33 0 . A coronary angiogram+/-intervention is then performed followed by 24 hours of cooling, ventilation and hemodynamic support. Results: Three MICA units have been trained on the trial protocol and use of the Autopulse since September 2011. Issues of percutaneous insertion of ECMO during active CPR have been significantly assisted by real time vascular ultrasound. Five patients have experienced refractory OHCA (VF>60minutes). In 4 patients return of spontaneous circulation was achieved, with 3 patients (60%) making a complete neurological recovery with hospital discharge on Day 7, 8 and 9 respectively. Conclusions: Establishing an ECPR program with cooperation from local ambulance crews is feasible. Further research into the efficacy and resource implications of ECPR is needed.
ECMO AutoPulse Media Report Data Summary Total media types 4 Total items 30 Total audience 3,841,870 Total ASR (in AUD) $662,121 Analysis Commentary Public Affairs generated a number of positive media mentions on the release of Professor Stephan Bernard’s research, the CHEER study. An Analysis of coverage produced in the 14 days between 08 May 2013 and 21 May 2013 found 30 media items. This media coverage reached a cumulative audience of 3,841,870 and when compared to equivalent advertising space achieved advertising space rate of AUD $662,121. * TV had the highest volume of coverage (15 items or 50% of the total volume of coverage) * TV reached the highest cumulative audience (2,921,000 items or 76% of the cumulative audience) * TV had the highest advertising space rate (AUD $523,503 or 79% of the total advertising space rate) Media Type Volume Audience ASR (in AUD) TV AM Radio FM Radio Press 15 2,921,000 $523,503 8 311,200 $102,510 2 29,000 $1,457 5 580,670 $34,651 COPYRIGHT This report and its contents are for the use of iSentia's subscribers only and may not be provided to any third party for any purpose whatsoever without the express written permission of iSentia. DISCLAIMER The material contained in this report is for general information purposes only. Any figures in this report are an estimation and should not be taken as definitive statistics. Subscribers should refer to the original article before making any financial decisions or forming any opinions. iSentia makes no representations and, to the extent permitted by law, excludes all warranties in relation to the information contained in the report and is not liable to you or to any third party for any losses, costs or expenses, resulting from any use or misuse.
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