The ICU-Resuscitation Project (ICU-RESUS)
Condition: Cardiac Arrest
MeSH terms: Heart Arrest
Study type: Interventional

Summary: 
      Pediatric cardiac arrest affects thousands of hospitalized children each year. High quality
      cardiopulmonary resuscitation (CPR) saves lives, but is difficult to achieve. The objective
      of this study is to determine if a novel patient-centric resuscitation care improvement
      bundle consisting of bedside CPR training and multidisciplinary reviews of each cardiac
      arrest improves CPR quality and survival outcomes in a multi-center trial.
    

Detailed description: 
      Pediatric cardiac arrest affects thousands of hospitalized children each year. Progressive
      heart and lung failure is a predisposing cause in the majority of these events. While cardiac
      arrest survival outcomes have improved over the last decade, more than half of these children
      will not live to hospital discharge. As brain injury complicates care in those who do
      survive, the burden to these children and the public's health is substantial.

      Cardiopulmonary resuscitation (CPR) - the medical procedure of providing chest compressions
      and ventilations during cardiac arrest - is life saving, and higher quality CPR is more
      effective at doing so. However, providing high quality care during the resuscitation of a
      child is difficult. Attempts to improve care through conventional training methods have not
      been successful; therefore, interventions to improve the quality of pediatric CPR and
      outcomes are needed.

      The objective of this study is to determine if a novel resuscitation care improvement bundle
      that improved outcomes in a single center intensive care unit (ICU) efficacy study is
      generalizable to other pediatric institutions in a multi-center effectiveness trial. The
      ICU-Resuscitation (ICU-RESUS) bundle includes: 1) CPR training at the point-of-care (in the
      ICU rather than a classroom away from patients); and 2) interdisciplinary structured reviews
      of each cardiac arrest that emphasize patient-centric physiology intended to optimize
      intra-arrest and post-arrest care. The ICU-RESUS bundle substantially improved CPR quality
      and nearly doubled the number of children surviving their event during the single center
      efficacy trial. In this study, a multi-institutional parallel stepped-wedge hybrid
      cluster-randomized trial, which leverages the existing infrastructure of the National
      Institute of Child Health and Human Development (NICHD)-funded Collaborative Pediatric
      Critical Care Research Network (CPCCRN), is proposed with the following aims: 1) Evaluate the
      effectiveness of the ICU-RESUS interventional bundle to improve outcomes of children treated
      for an ICU cardiac arrest; and 2) Evaluate the effectiveness of the ICU-RESUS interventional
      bundle to improve the quality of CPR provided by ICU healthcare providers in the population
      of children treated for an ICU cardiac arrest.
    

Intervention name(s): ICU-RESUS CPR Improvement Bundle
Intervention type(s): Other
Intervention description(s): Point-of-care CPR training
Post-cardiac arrest educational debriefings
Other intervention name(s): ICU-RESUS
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: pediatric; heart arrest