About this trial
To give chest compressions during cardiopulmonary resuscitation (CPR), mechanical chest compression devices can be used. During synchronous 30:2 CPR, the standard setting on these devices leave an automated 3-second chest compression pause after 30 compressions to facilitate caregivers in providing two ventilations. With this standard setting, research has shown that in less than half of ventilation pauses during CPR, those two ventilations are given. Increasing the ventilation pause duration to 5 seconds instead of 3 seconds is also an option following current guideline recommendations, and aligns with measured ventilation pause duration in manual CPR. Increasing pause duration to 5 seconds could result in an increased ventilation success rate. This multicenter randomized controlled trial will randomize LUCAS® mechanical compression devices to a standard setting of 3- or 5-second compression pauses. The main outcome will be the percentage of ventilation pauses in which two ventilations are successfully given. Secondary outcomes include the restoration of spontaneous circulation (ROSC), and the difference in (neurologically intact) survival. No study has been performed to evaluate this effect yet.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Adults (≥16 years of age)
OHCA patients with an attempt at cardiopulmonary resuscitation (CPR) by ambulance personnel
LUCAS® 3.1 has been used during the resuscitation attempt
Disqualifiers
Missing ambulance run report, missing or unclear impedance signal (measurement of resistance across the thorax), making it impossible to assess the number of ventilation pauses
Absence of a minimum of 3 assessable pauses intended for ventilation after connecting the LUCAS®
Trial design
Parallel
Treatments tested in this trial
5-second ventilation pause duration during mechanical CPR
Other interventionThe intervention is a 5-second lasting ventilation pause during mechanical CPR
3-second ventilation pause duration during mechanical CPR
Other interventionThe intervention is a 3-second lasting ventilation pause during mechanical CPR
Treatment groups
Trial outcomes
Primary outcomes
Percentage of ventilation pauses in which two ventilations are given
The difference in percentage of ventilation pauses in which two ventilations are given between the intervention and control group
Secondary outcomes
Return of spontaneous circulation (ROSC)
The difference in percentage of participants with and without ROSC
Cerebral performance score (CPC score) at hospital discharge (CPC 1-2 vs. 3-4)
The difference in percentage of participants with a CPC of 1-2 (good neurological recovery) vs. 3-4 (poor neurological recovery) at hospital discharge CPC score system: 1. Normal (good cerebral performance) 2. Moderate disability (disabled but independent) 3. Severe disability (conscious but disabled and dependent) 4. Unconscious (coma or vegetative state)
Survival to hospital discharge
The difference in percentage of participants with and without survival to hospital discharge
30-day survival
The difference in percentage of participants with and without survival at 30 days after the cardiac arrest
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