2CHEER is a multi-centre clinical trial about to begin in Sydney in co-operation with St Vincents Hospital and Royal Prince Alfred Hospitals and NSW Ambulance Service. The trial is an extension of the very successful (though small) feasibility trial called the CHEER Study. This trial examined whether technology called ECMO (extra-corporeal membrane oxygenation) could improve survival following Sudden Cardiac Arrest in a population who have no chance of survival in current paradigms – cardiac arrest unresponsive to 30min of ACLS.
CHEER was conducted in Melbourne and collected 26 patients in just under 3 years. The study incorporated mechanical CPR to allow safe and effective closed chest compressions during transport as well as in-arrest cooling. Once a patient was established on ECMO they were taken to the Cardiac Catheterisation Laboratory to treat any underlying coronary occlusion. The results were incredible and have rejuvenated enthusiasm for the concept of trying harder and smarter to save those patients “Too Young to Die” around the world.
You can read the trial itself here:
Professor Steven Bernard presented a great talk on the study here just its before publication which sets the background, the aims, challenges and results obtained in this landmark study:
For more information here is some further commentary on this and a similar trial from the “FOAM world” (Free Open-Access Medical Education)
For NSW Ambulance Paramedics participating in 2CHEER, the trial is a great opportunity to gain experience using mechanical CPR in the prehospital phase of care and the study materials here are focussed on use of that technology in particular. Before we get to the nitty gritty it is worth exploring what we are trying to achieve in our prehospital management of Sudden Cardiac Arrest.