Patients resuscitated after cardiac arrest without ST elevation had the same survival if they were transported to the nearest hospital emergency department or a cardiac arrest center, in the UK ARREST trial.
Observational studies of registry data suggest that postarrest care for patients resuscitated after cardiac arrest, without ST-segment elevation, may be best delivered in a specialized center, she noted.
She drew attention to two findings: First, among the 862 patients who were enrolled, whom paramedics judged as being without an obvious noncardiac cause of the cardiac arrest,"only 60% ended up having a cardiac cause for their cardiac arrest and only around one quarter of the total hadThe small number of patients who could have benefitted from early access to a catheterization laboratory probably contributed to the negative result obtained in this trial, with the loss of statistical power,...
Asked during the press conference here why the results were so different from the registry study findings, Redwood said,"We've seen time and time again that registry data think they are telling us the answer. They're actually not." Zannad wanted to know how informed consent was obtained. Patterson noted that they have an excellent ethical committee that allowed them to undertake this research in vulnerable patients. Written informed consent was obtained from the patient once the initial emergency had passed if they had regained capacity."It's very well established that early bystander CPR [cardiopulmonary resuscitation], early defibrillation, and advanced in-hospital care improves survival," Redwood noted.
Mortality at 3 months was similar in both groups: 64% in the standard care group and 65% in the cardiac arrest center group.Eight of 414 patients in the cardiac arrest center group and three of 413 in the standard care group had serious adverse events, none of which were deemed related to the trial intervention.
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