Study of Positive End-Expiratory Pressure Use During CPR for Adults with Out-of-Hospital Cardiac Arrest to Improve Heart Restart and Survival Outcomes

What this Trial Is About

This clinical trial focuses on adults who experience out-of-hospital cardiac arrest, where the heart suddenly stops beating. Researchers are studying whether using Positive End-Expiratory Pressure PEEP during cardiopulmonary resuscitation CPR improves outcomes such as restarting the heart, survival rates, and neurological function compared to standard CPR without PEEP. This study is a phase 3 randomized trial addressing a gap in knowledge about ventilation during CPR and its impact on patient outcomes. Participants are randomly assigned to one of two groups one receives CPR with PEEP set at 5 cm H2O using an adult resuscitation bag with a disposable PEEP valve, and the other receives standard CPR without PEEP using the same type of resuscitation bag but without the PEEP valve. Ventilation and airway pressures are monitored with specialized sensors during resuscitation by advanced life support medical teams. The study evaluates both effectiveness and safety, including potential side effects like increased chest pressure or lung injury. During the study, participants return of spontaneous circulation ROSC is measured as the primary outcome. Secondary outcomes include survival to hospital admission and discharge, 30- and 90-day survival, and neurological function at discharge. Data on CPR quality and physiological measurements are collected. The trial follows participants from enrollment through hospital discharge or death, with detailed monitoring of outcomes and safety to guide future CPR guidelines.

The Application of Positive End-Expiratory Pressure in Out-of-Hospital Cardiac Arrest: The Lazarus-PEEP Trial.