The aim of the study is to investigate whether occluding the abdominal aorta with an external device could be a potential therapeutic option in cases of non-traumatic cardiac arrest occurring outside of a hospital.
In cardiac arrest, the heart suddenly stops beating, causing the circulation of blood to collapse. In this situation, vital organs-especially the brain and the heart itself-are no longer adequately supplied with oxygen. Without immediate treatment, severe damage or death occurs within minutes.
The study therefore examines a specific intervention: the temporary occlusion of the abdominal aorta, which carries blood to the lower regions of the body. If this artery is blocked for a short period, the available blood can be redirected more effectively to the upper parts of the body. In theory, this could improve the oxygen supply to these organs and increase the likelihood that the heart will resume beating or that neurological damage can be reduced.
Cardiac arrest with indication for initiation of resuscitation
Age ≥ 18 years
Pregnancy (suspected or confirmed)
Age < 18 years
Abdominal circumference does not allow application of the AAJT
Traumatic etiology
Single group
Abdominal Aortic Junction Tourniquet in non-traumatic out-of-hospital cardiac arrest
DeviceIf a patient is found in cardiac arrest, eligibility is assessed. If the patient is deemed eligible, the following steps are performed: 1. Initiation of standard Advanced Cardiac Life Support (ACLS) 2. Endotracheal intubation and controlled mandatory ventilation according to ERC 2025 guidelines 3. Initiation of mechanical CPR 4. Arterial cannulation of an artery in the left upper extremity; access via the right upper extremity may be attempted after two unsuccessful attempts 5. Exclusion of reversible causes based on clinical history, physical examination, and/or ultrasound 6. Inflation of the AAJT 7. Device removal and termination of resuscitation (TOR) if ERC criteria are met 8. If return of spontaneous circulation (ROSC) is achieved, the AAJT remains in place until normotension is established, either spontaneously or with vasopressor support
Time from initiation of AAJT application to complete inflation
Time from dispatch to application
time from arrival on scene to application
time from initiation of resuscitation to application
change in end-tidal CO₂ (etCO₂) measured in mmHg
In patients admitted to the hospital with ROSC who underwent CT of the thorax and abdomen: percentage of patients with intrathoracic injuries; percentage of patients with intra-abdominal injuries
Analysis of the CT-report with regards to findings of device related intrathoracic or intraabdominal injuries
In patients without ROSC in whom an autopsy was performed: percentage of patients with intrathoracic injuries; percentage of patients with intra-abdominal injuries
Analysis of the autopsy-report with regards to findings of device related intrathoracic or intraabdominal injuries
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