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4. An efficacy and mechanism evaluation study of Levosimendan for the Prevention of Acute oRgan Dysfunction in Sepsis (LeoPARDS): Protocol for a randomized controlled trial

Author

Liu, Kathleen, Orme, RML, Perkins, GD, McAuley, DF, Liu, KD, Mason, AJ, Morelli, A, Singer, M, Ashby, D, and Gordon, AC

Abstract

Background: Organ dysfunction consequent to infection ('severe sepsis') is the leading cause of admission to an intensive care unit (ICU). In both animal models and early clinical studies the calcium channel sensitizer levosimendan has been demonstrated to

Published
2014

6. S44 Repair of acute respiratory distress syndrome in COVID-19 by stromal cells (REALIST-COVID trial): 1 year follow up for safety and pulmonary dysfunction

Author

Gardiner, HJ, primary, Gorman, EA, additional, Rostron, AJ, additional, Shankar-Hari, M, additional, Bannard-Smith, J, additional, Bentley, AM, additional, Brealey, D, additional, Campbell, C, additional, Curley, G, additional, Clarke, M, additional, Dushianthan, A, additional, Hopkins, P, additional, Jackson, C, additional, Kefela, K, additional, Laffey, JG, additional, McDowell, C, additional, McFarland, M, additional, McFerran, J, additional, McGuigan, P, additional, Perkins, GD, additional, Silversides, J, additional, Smythe, J, additional, Thompson, J, additional, Tunnicliffe, WS, additional, Welters, IDM, additional, Williams, B, additional, McAuley, DF, additional, and O’Kane, CM, additional

Published
2022
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7. 2021 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations

Author

Wyckoff, MH, Singletary, EM, Soar, J, Olasveengen, TM, Greif, R, Liley, HG, Zideman, D, Bhanji, F, Andersen, LW, Avis, SR, Aziz, K, Bendall, JC, Berry, DC, Borra, V, Böttiger, BW, Bradley, R, Bray, JE, Breckwoldt, J, Carlson, JN, Cassan, P, Castrén, M, Chang, WT, Charlton, NP, Cheng, A, Chung, SP, Costa-Nobre, DT, Dainty, KN, Davis, PG, de Almeida, MF, de Caen, AR, de Paiva, EF, Deakin, CD, Djärv, T, Douma, MJ, Drennan, IR, Duff, JP, Eastwood, KJ, El-Naggar, W, Epstein, JL, Escalante, R, Fabres, JG, Fawke, J, Finn, JC, Foglia, EE, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, CA, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, MF, Heriot, GS, Hirsch, KG, Holmberg, MJ, Hosono, S, Hsieh, MJ, Hung, KKC, Hsu, CH, Ikeyama, T, Isayama, T, Kapadia, VS, Kawakami, MD, Kim, HS, Kloeck, DA, Kudenchuk, PJ, Lagina, AT, Lauridsen, KG, Lavonas, EJ, Lockey, AS, Hansen, CM, Markenson, D, Matsuyama, T, McKinlay, CJD, Mehrabian, A, Merchant, RM, Meyran, D, Morley, PT, Morrison, LJ, Nation, KJ, Nemeth, M, Neumar, RW, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O’Neil, BJ, Orkin, AM, Osemeke, O, Parr, MJ, Patocka, C, Pellegrino, JL, Perkins, GD, Perlman, JM, Rabi, Y, Reynolds, JC, Ristagno, G, Roehr, CC, Sakamoto, T, Sandroni, C, Considine, Julie, Wyckoff, MH, Singletary, EM, Soar, J, Olasveengen, TM, Greif, R, Liley, HG, Zideman, D, Bhanji, F, Andersen, LW, Avis, SR, Aziz, K, Bendall, JC, Berry, DC, Borra, V, Böttiger, BW, Bradley, R, Bray, JE, Breckwoldt, J, Carlson, JN, Cassan, P, Castrén, M, Chang, WT, Charlton, NP, Cheng, A, Chung, SP, Costa-Nobre, DT, Dainty, KN, Davis, PG, de Almeida, MF, de Caen, AR, de Paiva, EF, Deakin, CD, Djärv, T, Douma, MJ, Drennan, IR, Duff, JP, Eastwood, KJ, El-Naggar, W, Epstein, JL, Escalante, R, Fabres, JG, Fawke, J, Finn, JC, Foglia, EE, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, CA, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, MF, Heriot, GS, Hirsch, KG, Holmberg, MJ, Hosono, S, Hsieh, MJ, Hung, KKC, Hsu, CH, Ikeyama, T, Isayama, T, Kapadia, VS, Kawakami, MD, Kim, HS, Kloeck, DA, Kudenchuk, PJ, Lagina, AT, Lauridsen, KG, Lavonas, EJ, Lockey, AS, Hansen, CM, Markenson, D, Matsuyama, T, McKinlay, CJD, Mehrabian, A, Merchant, RM, Meyran, D, Morley, PT, Morrison, LJ, Nation, KJ, Nemeth, M, Neumar, RW, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O’Neil, BJ, Orkin, AM, Osemeke, O, Parr, MJ, Patocka, C, Pellegrino, JL, Perkins, GD, Perlman, JM, Rabi, Y, Reynolds, JC, Ristagno, G, Roehr, CC, Sakamoto, T, Sandroni, C, and Considine, Julie

Published
2022

9. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

Author

Wyckoff, Mh, Singletary, Em, Soar, J, Olasveengen, Tm, Greif, R, Liley, Hg, Zideman, D, Bhanji, F, Andersen, Lw, Avis, Sr, Aziz, K, Bendall, Jc, Berry, Dc, Borra, V, Bottiger, Bw, Bradley, R, Bray, Je, Breckwoldt, J, Carlson, Jn, Cassan, P, Castren, M, Chang, Wt, Charlton, Np, Cheng, A, Chung, Sp, Considine, J, Costa-Nobre, Dt, Couper, K, Dainty, Kn, Davis, Pg, de Almeida, Mf, de Caen, Ar, de Paiva, Ef, Deakin, Cd, Djarv, T, Douma, Mj, Drennan, Ir, Duff, Jp, Eastwood, Kj, El-Naggar, W, Epstein, Jl, Escalante, R, Fabres, Jg, Fawke, J, Finn, Jc, Foglia, Ee, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, Ca, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, Mf, Heriot, G, Hirsch, Kg, Holmberg, Mj, Hosono, S, Hsieh, Mj, Hung, Kkc, Hsu, Ch, Ikeyama, T, Isayama, T, Kapadia, V, Kawakami, Md, Kim, H, Kloeck, Da, Kudenchuk, Pj, Lagina, At, Lauridsen, Kg, Lavonas, Ej, Lockey, A, Hansen, Cm, Markenson, D, Matsuyama, T, McKinlay, Cjd, Mehrabian, A, Merchant, Rm, Meyran, D, Morley, Pt, Morrison, Lj, Nation, Kj, Nemeth, M, Neumar, Rw, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, Bj, Orkin, Am, Osemeke, O, Parr, Mj, Patocka, C, Pellegrino, Jl, Perkins, Gd, Perlman, Jm, Rabi, Y, Reynolds, Jc, Ristagno, G, Roehr, Cc, Sakamoto, T, Sandroni, C, Sawyer, T, Schmolzer, Gm, Schnaubelt, S, Semeraro, F, Skrifvars, Mb, Smith, Cm, Smyth, Ma, Soll, Rf, Sugiura, T, Taylor-Phillips, S, Trevisanuto, D, Vaillancourt, C, Wang, Tl, Weiner, Gm, Welsford, M, Wigginton, J, Wyllie, Jp, Yeung, J, Nolan, Jp, Berg, Km, Sandroni, C (ORCID:0000-0002-8878-2611), Wyckoff, Mh, Singletary, Em, Soar, J, Olasveengen, Tm, Greif, R, Liley, Hg, Zideman, D, Bhanji, F, Andersen, Lw, Avis, Sr, Aziz, K, Bendall, Jc, Berry, Dc, Borra, V, Bottiger, Bw, Bradley, R, Bray, Je, Breckwoldt, J, Carlson, Jn, Cassan, P, Castren, M, Chang, Wt, Charlton, Np, Cheng, A, Chung, Sp, Considine, J, Costa-Nobre, Dt, Couper, K, Dainty, Kn, Davis, Pg, de Almeida, Mf, de Caen, Ar, de Paiva, Ef, Deakin, Cd, Djarv, T, Douma, Mj, Drennan, Ir, Duff, Jp, Eastwood, Kj, El-Naggar, W, Epstein, Jl, Escalante, R, Fabres, Jg, Fawke, J, Finn, Jc, Foglia, Ee, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, Ca, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, Mf, Heriot, G, Hirsch, Kg, Holmberg, Mj, Hosono, S, Hsieh, Mj, Hung, Kkc, Hsu, Ch, Ikeyama, T, Isayama, T, Kapadia, V, Kawakami, Md, Kim, H, Kloeck, Da, Kudenchuk, Pj, Lagina, At, Lauridsen, Kg, Lavonas, Ej, Lockey, A, Hansen, Cm, Markenson, D, Matsuyama, T, McKinlay, Cjd, Mehrabian, A, Merchant, Rm, Meyran, D, Morley, Pt, Morrison, Lj, Nation, Kj, Nemeth, M, Neumar, Rw, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, Bj, Orkin, Am, Osemeke, O, Parr, Mj, Patocka, C, Pellegrino, Jl, Perkins, Gd, Perlman, Jm, Rabi, Y, Reynolds, Jc, Ristagno, G, Roehr, Cc, Sakamoto, T, Sandroni, C, Sawyer, T, Schmolzer, Gm, Schnaubelt, S, Semeraro, F, Skrifvars, Mb, Smith, Cm, Smyth, Ma, Soll, Rf, Sugiura, T, Taylor-Phillips, S, Trevisanuto, D, Vaillancourt, C, Wang, Tl, Weiner, Gm, Welsford, M, Wigginton, J, Wyllie, Jp, Yeung, J, Nolan, Jp, Berg, Km, and Sandroni, C (ORCID:0000-0002-8878-2611)

Abstract

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.

Published
2022

10. SARS-CoV-2 environmental contamination from hospitalised COVID-19 patients receiving aerosol generating procedures

Author

Winslow, RL, primary, Zhou, J, additional, Windle, EF, additional, Nur, I, additional, Lall, R, additional, Ji, C, additional, Millar, JE, additional, Dark, P, additional, Naisbitt, J, additional, Simonds, A, additional, Dunning, J, additional, Barclay, W, additional, Baillie, K, additional, Perkins, GD, additional, Semple, MG, additional, McAuley, DF, additional, and Green, CA, additional

Published
2021
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11. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams

Author

Wyckoff, MH, Singletary, EM, Soar, J, Olasveengen, TM, Greif, R, Liley, HG, Zideman, D, Bhanji, F, Andersen, LW, Avis, SR, Aziz, K, Bendall, JC, Berry, DC, Borra, V, Böttiger, BW, Bradley, R, Bray, JE, Breckwoldt, J, Carlson, JN, Cassan, P, Castrén, M, Chang, WT, Charlton, NP, Cheng, A, Chung, SP, Considine, Julie, Costa-Nobre, DT, Couper, K, Dainty, KN, Davis, PG, de Almeida, MF, de Caen, AR, de Paiva, EF, Deakin, CD, Djärv, T, Douma, MJ, Drennan, IR, Duff, JP, Eastwood, KJ, El-Naggar, W, Epstein, JL, Escalante, R, Fabres, JG, Fawke, J, Finn, JC, Foglia, EE, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, CA, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, MF, Heriot, GS, Hirsch, KG, Holmberg, MJ, Hosono, S, Hsieh, MJ, Hung, KKC, Hsu, CH, Ikeyama, T, Isayama, T, Kapadia, VS, Kawakami, MD, Kim, HS, Kloeck, DA, Kudenchuk, PJ, Lagina, AT, Lauridsen, KG, Lavonas, EJ, Lockey, AS, Malta Hansen, C, Markenson, D, Matsuyama, T, McKinlay, CJD, Mehrabian, A, Merchant, RM, Meyran, D, Morley, PT, Morrison, LJ, Nation, KJ, Nemeth, M, Neumar, RW, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, BJ, Orkin, AM, Osemeke, O, Parr, MJ, Patocka, C, Pellegrino, JL, Perkins, GD, Perlman, JM, Rabi, Y, Reynolds, JC, Ristagno, G, Roehr, CC, Wyckoff, MH, Singletary, EM, Soar, J, Olasveengen, TM, Greif, R, Liley, HG, Zideman, D, Bhanji, F, Andersen, LW, Avis, SR, Aziz, K, Bendall, JC, Berry, DC, Borra, V, Böttiger, BW, Bradley, R, Bray, JE, Breckwoldt, J, Carlson, JN, Cassan, P, Castrén, M, Chang, WT, Charlton, NP, Cheng, A, Chung, SP, Considine, Julie, Costa-Nobre, DT, Couper, K, Dainty, KN, Davis, PG, de Almeida, MF, de Caen, AR, de Paiva, EF, Deakin, CD, Djärv, T, Douma, MJ, Drennan, IR, Duff, JP, Eastwood, KJ, El-Naggar, W, Epstein, JL, Escalante, R, Fabres, JG, Fawke, J, Finn, JC, Foglia, EE, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, CA, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, MF, Heriot, GS, Hirsch, KG, Holmberg, MJ, Hosono, S, Hsieh, MJ, Hung, KKC, Hsu, CH, Ikeyama, T, Isayama, T, Kapadia, VS, Kawakami, MD, Kim, HS, Kloeck, DA, Kudenchuk, PJ, Lagina, AT, Lauridsen, KG, Lavonas, EJ, Lockey, AS, Malta Hansen, C, Markenson, D, Matsuyama, T, McKinlay, CJD, Mehrabian, A, Merchant, RM, Meyran, D, Morley, PT, Morrison, LJ, Nation, KJ, Nemeth, M, Neumar, RW, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, BJ, Orkin, AM, Osemeke, O, Parr, MJ, Patocka, C, Pellegrino, JL, Perkins, GD, Perlman, JM, Rabi, Y, Reynolds, JC, Ristagno, G, and Roehr, CC

Published
2021

12. The effect of alternative methods of cardiopulmonary resuscitation - Cough CPR, percussion pacing or precordial thump - on outcomes following cardiac arrest. A systematic review

Author

Dee, R, Smith, M, Rajendran, K, Perkins, GD, Smith, CM, Vaillancourt, C, Avis, S, Brooks, S, Castren, M, Chung, SP, Considine, J, Escalante, R, Han, LS, Hatanaka, T, Hazinski, MF, Hung, K, Kudenchuk, P, Morley, P, Ng, K-C, Nishiyama, C, Semeraro, F, Smyth, M, Dee, R, Smith, M, Rajendran, K, Perkins, GD, Smith, CM, Vaillancourt, C, Avis, S, Brooks, S, Castren, M, Chung, SP, Considine, J, Escalante, R, Han, LS, Hatanaka, T, Hazinski, MF, Hung, K, Kudenchuk, P, Morley, P, Ng, K-C, Nishiyama, C, Semeraro, F, and Smyth, M

Abstract

BACKGROUND: Cardiopulmonary resuscitation (CPR) improves cardiac arrest survival. Cough CPR, percussion pacing and precordial thump have been reported as alternative CPR techniques. We aimed to summarise in a systematic review the effectiveness of these alternative CPR techniques. METHODS: We searched Ovid MEDLINE, EMBASE and the Cochrane Library on 24/08/2020. We included randomised controlled trials, observational studies and case series with five or more patients. Two reviewers independently reviewed title and abstracts to identify studies for full-text review, and reviewed bibliographies and 'related articles' (using PubMed) of full-texts for further eligible studies. We extracted data and performed risk-of-bias assessments on studies included in the systematic review. We summarised data in a narrative synthesis, and used GRADE to assess evidence certainty. RESULTS: We included 23 studies (cough CPR n = 4, percussion pacing n = 4, precordial thump n = 16; one study studied two interventions). Only two (both precordial thump) had a comparator group ('standard' CPR). For all techniques evidence certainty was very low. Available evidence suggests that precordial thump does not improve survival to hospital discharge in out-of-hospital cardiac arrest. The review did not find evidence that cough CPR or percussion pacing improve clinical outcomes following cardiac arrest. CONCLUSION: Cough CPR, percussion pacing and precordial thump should not be routinely used in established cardiac arrest. In specific inpatient, monitored settings cough CPR (in conscious patients) or percussion pacing may be attempted at the onset of a potential lethal arrhythmia. These must not delay standard CPR efforts in those who lose cardiac output. PROSPERO REGISTRATION NUMBER: CRD42019152925.

Published
2021

13. Adult basic life support: international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations

Author

Olasveengen, TM, Mancini, ME, Perkins, GD, Avis, S, Brooks, S, Castrén, M, Chung, SP, Considine, Julie, Couper, K, Escalante, R, Hatanaka, T, Hung, KKC, Kudenchuk, P, Lim, SH, Nishiyama, C, Ristagno, G, Semeraro, F, Smith, CM, Smyth, MA, Vaillancourt, C, Nolan, JP, Hazinski, MF, Morley, PT, Svavarsdóttir, H, Raffay, V, Kuzovlev, A, Grasner, JT, Dee, R, Smith, M, Rajendran, K, Olasveengen, TM, Mancini, ME, Perkins, GD, Avis, S, Brooks, S, Castrén, M, Chung, SP, Considine, Julie, Couper, K, Escalante, R, Hatanaka, T, Hung, KKC, Kudenchuk, P, Lim, SH, Nishiyama, C, Ristagno, G, Semeraro, F, Smith, CM, Smyth, MA, Vaillancourt, C, Nolan, JP, Hazinski, MF, Morley, PT, Svavarsdóttir, H, Raffay, V, Kuzovlev, A, Grasner, JT, Dee, R, Smith, M, and Rajendran, K

Published
2020

14. Adult Basic Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Author

Olasveengen, TM, Mancini, ME, Perkins, GD, Avis, S, Brooks, S, Castrén, M, Chung, SP, Considine, Julie-Anne, Couper, K, Escalante, R, Hatanaka, T, Hung, KKC, Kudenchuk, P, Lim, SH, Nishiyama, C, Ristagno, G, Semeraro, F, Smith, CM, Smyth, MA, Vaillancourt, C, Nolan, JP, Hazinski, MF, Morley, PT, Olasveengen, TM, Mancini, ME, Perkins, GD, Avis, S, Brooks, S, Castrén, M, Chung, SP, Considine, Julie-Anne, Couper, K, Escalante, R, Hatanaka, T, Hung, KKC, Kudenchuk, P, Lim, SH, Nishiyama, C, Ristagno, G, Semeraro, F, Smith, CM, Smyth, MA, Vaillancourt, C, Nolan, JP, Hazinski, MF, and Morley, PT

Abstract

This 2020 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care Science With Treatment Recommendations on basic life support summarizes evidence evaluations performed for 22 topics that were prioritized by the Basic Life Support Task Force of the International Liaison Committee on Resuscitation. The evidence reviews include 16 systematic reviews, 5 scoping reviews, and 1 evidence update. Per agreement within the International Liaison Committee on Resuscitation, new or revised treatment recommendations were only made after a systematic review. Systematic reviews were performed for the following topics: dispatch diagnosis of cardiac arrest, use of a firm surface for CPR, sequence for starting CPR (compressions-airway-breaths versus airway-breaths-compressions), CPR before calling for help, duration of CPR cycles, hand position during compressions, rhythm check timing, feedback for CPR quality, alternative techniques, public access automated external defibrillator programs, analysis of rhythm during chest compressions, CPR before defibrillation, removal of foreign-body airway obstruction, resuscitation care for suspected opioid-associated emergencies, drowning, and harm from CPR to victims not in cardiac arrest. The topics that resulted in the most extensive task force discussions included CPR during transport, CPR before calling for help, resuscitation care for suspected opioid-associated emergencies, feedback for CPR quality, and analysis of rhythm during chest compressions. After discussion of the scoping reviews and the evidence update, the task force prioritized several topics for new systematic reviews.

Published
2020

15. COVID-19 in cardiac arrest and infection risk to rescuers: A systematic review

Author

Couper, K, Taylor-Phillips, S, Grove, A, Freeman, K, Osokogu, O, Court, R, Mehrabian, A, Morley, PT, Nolan, JP, Soar, J, Perkins, GD, Couper, K, Taylor-Phillips, S, Grove, A, Freeman, K, Osokogu, O, Court, R, Mehrabian, A, Morley, PT, Nolan, JP, Soar, J, and Perkins, GD

Abstract

BACKGROUND: There may be a risk of COVID-19 transmission to rescuers delivering treatment for cardiac arrest. The aim of this review was to identify the potential risk of transmission associated with key interventions (chest compressions, defibrillation, cardiopulmonary resuscitation) to inform international treatment recommendations. METHODS: We undertook a systematic review comprising three questions: (1) aerosol generation associated with key interventions; (2) risk of airborne infection transmission associated with key interventions; and (3) the effect of different personal protective equipment strategies. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the World Health Organization COVID-19 database on 24th March 2020. Eligibility criteria were developed individually for each question. We assessed risk of bias for individual studies, and used the GRADE process to assess evidence certainty by outcome. RESULTS: We included eleven studies: two cohort studies, one case control study, five case reports, and three manikin randomised controlled trials. We did not find any direct evidence that chest compressions or defibrillation either are or are not associated with aerosol generation or transmission of infection. Data from manikin studies indicates that donning of personal protective equipment delays treatment delivery. Studies provided only indirect evidence, with no study describing patients with COVID-19. Evidence certainty was low or very low for all outcomes. CONCLUSION: It is uncertain whether chest compressions or defibrillation cause aerosol generation or transmission of COVID-19 to rescuers. There is very limited evidence and a rapid need for further studies. Review registration: PROSPERO CRD42020175594.

Published
2020

16. International Liaison Committee on Resuscitation: COVID-19 consensus on science, treatment recommendations and task force insights

Author

Perkins, GD, Morley, PT, Nolan, JP, Soar, J, Berg, K, Olasveengen, T, Wyckoff, M, Greif, R, Singletary, N, Castren, M, de Caen, A, Wang, T, Escalante, R, Merchant, RM, Hazinski, M, Kloeck, D, Heriot, G, Couper, K, Neumar, R, Perkins, GD, Morley, PT, Nolan, JP, Soar, J, Berg, K, Olasveengen, T, Wyckoff, M, Greif, R, Singletary, N, Castren, M, de Caen, A, Wang, T, Escalante, R, Merchant, RM, Hazinski, M, Kloeck, D, Heriot, G, Couper, K, and Neumar, R

Abstract

Consensus on Science and Treatment recommendations aim to balance the benefits of early resuscitation with the potential for harm to care providers during the COVID-19 pandemic. Chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols. During the current COVID-19 pandemic lay rescuers should consider compressions and public-access defibrillation. Lay rescuers who are willing, trained and able to do so, should consider providing rescue breaths to infants and children in addition to chest compressions. Healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation and may consider defibrillation before donning personal protective equipment for aerosol generating procedures.

Published
2020

17. Executive Summary 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Author

Nolan, JP, Maconochie, I, Soar, J, Olasveengen, TM, Greif, R, Wyckoff, MH, Singletary, EM, Aickin, R, Berg, KM, Mancini, ME, Bhanji, F, Wyllie, J, Zideman, D, Neumar, RW, Perkins, GD, Castren, M, Morley, PT, Montgomery, WH, Nadkarni, VM, Billi, JE, Merchant, RM, de Caen, A, Escalante-Kanashiro, R, Kloeck, D, Wang, T-L, Hazinski, MF, Nolan, JP, Maconochie, I, Soar, J, Olasveengen, TM, Greif, R, Wyckoff, MH, Singletary, EM, Aickin, R, Berg, KM, Mancini, ME, Bhanji, F, Wyllie, J, Zideman, D, Neumar, RW, Perkins, GD, Castren, M, Morley, PT, Montgomery, WH, Nadkarni, VM, Billi, JE, Merchant, RM, de Caen, A, Escalante-Kanashiro, R, Kloeck, D, Wang, T-L, and Hazinski, MF

Published
2020

18. Chest compression components (rate, depth, chest wall recoil and leaning): A scoping review

Author

Considine, J, Gazmuri, RJ, Perkins, GD, Kudenchuk, PJ, Olasveengen, TM, Vaillancourt, C, Nishiyama, C, Hatanaka, T, Mancini, ME, Chung, SP, Escalante-Kanashiro, R, Morley, P, Considine, J, Gazmuri, RJ, Perkins, GD, Kudenchuk, PJ, Olasveengen, TM, Vaillancourt, C, Nishiyama, C, Hatanaka, T, Mancini, ME, Chung, SP, Escalante-Kanashiro, R, and Morley, P

Abstract

AIM: To understand whether the science to date has focused on single or multiple chest compression components and identify the evidence related to chest compression components to determine the need for a full systematic review. METHODS: This review was undertaken by members of the International Liaison Committee on Resuscitation and guided by a specific methodological framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Studies were eligible for inclusion if they were peer-reviewed human studies that examined the effect of different chest compression depths or rates, or chest wall or leaning, on physiological or clinical outcomes. The databases searched were MEDLINE complete, Embase, and Cochrane. RESULTS: Twenty-two clinical studies were included in this review: five observational studies involving 879 patients examined both chest compression rate and depth; eight studies involving 14,285 patients examined chest compression rate only; seven studies involving 12001 patients examined chest compression depth only, and two studies involving 1848 patients examined chest wall recoil. No studies were identified that examined chest wall leaning. Three studies reported an inverse relationship between chest compression rate and depth. CONCLUSION: This scoping review did not identify sufficient new evidence that would justify conducting new systematic reviews or reconsideration of current resuscitation guidelines. This scoping review does highlight significant gaps in the research evidence related to chest compression components, namely a lack of high-level evidence, paucity of studies of in-hospital cardiac arrest, and failure to account for the possibility of interactions between chest compression components.

Published
2020

21. Sugar or salt (“SOS”): A protocol for a UK multicentre randomised trial of mannitol and hypertonic saline in severe traumatic brain injury and intracranial hypertension

Author

Rowland, MJ, primary, Veenith, T, additional, Scomparin, C, additional, Wilson, MH, additional, Hutchinson, PJ, additional, Kolias, AG, additional, Lall, R, additional, Regan, S, additional, Mason, J, additional, Andrews, PJD, additional, Horner, D, additional, Naisbitt, J, additional, Devrell, A, additional, Malins, A, additional, Dark, P, additional, McAuley, DF, additional, and Perkins, GD, additional

Published
2020
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22. Sugar or Salt (“SOS”): a protocol for a UK multicentre randomised trial of mannitol and hypertonic saline in severe traumatic brain injury and intracranial hypertension

Author

Rowland, MJ, primary, Veenith, T, additional, Scomparin, C, additional, Wilson, MH, additional, Hutchinson, PJ, additional, Kolias, AG, additional, Lall, R, additional, Regan, S, additional, Mason, J, additional, Andrews, PJD, additional, Horner, D, additional, Naisbitt, J, additional, Devrell, A, additional, Malins, A, additional, Dark, P, additional, McAuley, DF, additional, and Perkins, GD, additional

Published
2019
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23. Effect of Early Vasopressin vs Norepinephrine on Kidney Failure in Patients With Septic Shock: The VANISH Randomized Clinical Trial

Author

Gordon, AC, Mason, AJ, Thirunavukkarasu, N, Perkins, GD, Cecconi, M, Cepkova, M, Pogson, DG, Aya, HD, Anjum, A, Frazier, GJ, Santhakumaran, S, Ashby, D, Brett, SJ, VANISH Investigators, COLLABORATORS, Warwick, J, Griffiths, S, Cross, M, Mason, A, Frazier, G, Das, N, Bellingan, G, Gordon, A, Brett, S, Perkins, G, Beale, R, Banks, F, Watts, T, Andrews, P, McAuley, D, Collier, T, Templeton, M, Errington, E, Gladas, K, Banach, D, Kitson, D, Matthew-Thomas, R, Hauer, V, Ochelli-Okpue, A, Stotz, M, Ostermann, M, Lei, K, Chan, K, Smith, J, Shankar-Hari, M, Carungcong, J, Handy, J, Hopkins, P, Harris, CL, Wade-Smith, F, Birch, S, Hurst, T, Mellinghoff, J, Di Tomasso, N, Ebm, C, Iannucceli, F, Kirwan, CJ, Creary, T, Correia, C, Prowle, JR, Jaques, N, Brown, A, Walden, A, Joscak, J, Bangalan, J, Tamm, T, Snow, L, Stapleton, C, Pahary, SM, Gould, T, Bewley, J, Sweet, K, Grimmer, L, Shah, S, Williams, S, Pulletz, M, Golder, K, Bolger, C, Salmon, K, Skinner, B, Vickers, E, Scott, M, Rose, S, Lamb, N, Mouland, J, Pogson, D, Bullock, L, Bland, M, Harrison-Briggs, D, Wilkinson, K, Krige, A, Ward, G, Ting, J, and Bassford, C

Abstract

Norepinephrine is currently recommended as the first-line vasopressor in septic shock; however, early vasopressin use has been proposed as an alternative. To compare the effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock. A factorial (2×2), double-blind, randomized clinical trial conducted in 18 general adult intensive care units in the United Kingdom between February 2013 and May 2015, enrolling adult patients who had septic shock requiring vasopressors despite fluid resuscitation within a maximum of 6 hours after the onset of shock. Patients were randomly allocated to vasopressin (titrated up to 0.06 U/min) and hydrocortisone (n = 101), vasopressin and placebo (n = 104), norepinephrine and hydrocortisone (n = 101), or norepinephrine and placebo (n = 103). The primary outcome was kidney failure-free days during the 28-day period after randomization, measured as (1) the proportion of patients who never developed kidney failure and (2) median number of days alive and free of kidney failure for patients who did not survive, who experienced kidney failure, or both. Rates of renal replacement therapy, mortality, and serious adverse events were secondary outcomes. A total of 409 patients (median age, 66 years; men, 58.2%) were included in the study, with a median time to study drug administration of 3.5 hours after diagnosis of shock. The number of survivors who never developed kidney failure was 94 of 165 patients (57.0%) in the vasopressin group and 93 of 157 patients (59.2%) in the norepinephrine group (difference, -2.3% [95% CI, -13.0% to 8.5%]). The median number of kidney failure-free days for patients who did not survive, who experienced kidney failure, or both was 9 days (interquartile range [IQR], 1 to -24) in the vasopressin group and 13 days (IQR, 1 to -25) in the norepinephrine group (difference, -4 days [95% CI, -11 to 5]). There was less use of renal replacement therapy in the vasopressin group than in the norepinephrine group (25.4% for vasopressin vs 35.3% for norepinephrine; difference, -9.9% [95% CI, -19.3% to -0.6%]). There was no significant difference in mortality rates between groups. In total, 22 of 205 patients (10.7%) had a serious adverse event in the vasopressin group vs 17 of 204 patients (8.3%) in the norepinephrine group (difference, 2.5% [95% CI, -3.3% to 8.2%]). Among adults with septic shock, the early use of vasopressin compared with norepinephrine did not improve the number of kidney failure-free days. Although these findings do not support the use of vasopressin to replace norepinephrine as initial treatment in this situation, the confidence interval included a potential clinically important benefit for vasopressin, and larger trials may be warranted to assess this further. clinicaltrials.gov Identifier: ISRCTN 20769191.

Published
2016

24. The Beta Agonist Lung Injury Trial Prevention

Author

Perkins, GD, Gates, S, Park, D, Gao, F, Knox, C, Holloway, B, McAuley, DF, Ryan, J, Marzouk, J, Cooke, MW, Lamb, SE, Thickett, DR, and Collaborators, BALTIP

Published
2016

26. 18 ‘Tell me what’s happened’: when linguistic choices affect efficiency of ambulance dispatch for cardiac arrest

Author

Riou, M, primary, Whiteside, A, additional, Ball, S, additional, Williams, T, additional, O’Halloran, KL, additional, Perkins, GD, additional, Bray, J, additional, Cameron, P, additional, Smith, K, additional, Fatovich, DM, additional, Inoue, M, additional, Brink, D, additional, Bailey, P, additional, and Finn, J, additional

Published
2017
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27. 15 The importance of staying on the call: recognition of cardiac arrest after initial dispatch

Author

Ball, S, primary, Whiteside, A, additional, Inoue, M, additional, Bray, J, additional, Fatovich, DM, additional, Cameron, P, additional, Williams, T, additional, Smith, K, additional, O’Halloran, KL, additional, Brink, D, additional, Perkins, GD, additional, Tohira, H, additional, Bailey, P, additional, Riou, M, additional, and Finn, J, additional

Published
2017
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28. pRotective vEntilation with veno-venouS lung assisT in respiratory failure: A protocol for a multicentre randomised controlled trial of extracorporeal carbon dioxide removal in patients with acute hypoxaemic respiratory failure

Author

McNamee, JJ, primary, Gillies, MA, additional, Barrett, NA, additional, Agus, AM, additional, Beale, R, additional, Bentley, A, additional, Bodenham, A, additional, Brett, SJ, additional, Brodie, D, additional, Finney, SJ, additional, Gordon, AJ, additional, Griffiths, M, additional, Harrison, D, additional, Jackson, C, additional, McDowell, C, additional, McNally, C, additional, Perkins, GD, additional, Tunnicliffe, W, additional, Vuylsteke, A, additional, Walsh, TS, additional, Wise, MP, additional, Young, D, additional, and McAuley, DF, additional

Published
2016
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29. European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances

Author

Truhlář, A, Deakin, Cd, Soar, J, Khalifa, Gea, Alfonzo, A, Bierens, Jjlm, Brattebø, G, Brugger, H, Dunning, J, Hunyadi Antičević, S, Koster, Rw, Lockey, Dj, Lott, C, Paal, P, Perkins, Gd, Sandroni, Claudio, Thies, K, Zideman, Da, Nolan, Jp, and Cardiology

Subjects
Settore MED/41 - ANESTESIOLOGIA, Electrolyte disorders, Hypothermia, Cardiac arrest, Trauma
Published
2015

35. Beta-Agonist Lung injury TrIal-2 (BALTI-2): a multicentre, randomised, double-blind, placebo-controlled trial and economic evaluation of intravenous infusion of salbutamol versus placebo in patients with acute respiratory distress syndrome

Author

Gates, S, primary, Perkins, GD, additional, Lamb, SE, additional, Kelly, C, additional, Thickett, DR, additional, Young, JD, additional, McAuley, DF, additional, Snaith, C, additional, McCabe, C, additional, Hulme, CT, additional, and Gao Smith, F, additional

Published
2013
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37. pRotective vEntilation with veno-venouS lung assisT in respiratory failure: A protocol for a multicentre randomised controlled trial of extracorporeal carbon dioxide removal in patients with acute hypoxaemic respiratory failure

Author

McNamee, JJ, Gillies, MA, Barrett, NA, Agus, AM, Beale, R, Bentley, A, Bodenham, A, Brett, SJ, Brodie, D, Finney, SJ, Gordon, AJ, Griffiths, M, Harrison, D, Jackson, C, McDowell, C, McNally, C, Perkins, GD, Tunnicliffe, W, Vuylsteke, A, Walsh, TS, Wise, MP, Young, D, and McAuley, DF

Abstract

One of the few interventions to demonstrate improved outcomes for acute hypoxaemic respiratory failure is reducing tidal volumes when using mechanical ventilation, often termed lung protective ventilation. Veno-venous extracorporeal carbon dioxide removal (vv-ECCO2R) can facilitate reducing tidal volumes. pRotective vEntilation with veno-venouS lung assisT (REST) is a randomised, allocation concealed, controlled, open, multicentre pragmatic trial to determine the clinical and cost-effectiveness of lower tidal volume mechanical ventilation facilitated by vv-ECCO2R in patients with acute hypoxaemic respiratory failure. Patients requiring intubation and mechanical ventilation for acute hypoxaemic respiratory failure will be randomly allocated to receive either vv-ECCO2R and lower tidal volume mechanical ventilation or standard care with stratification by recruitment centre. There is a need for a large randomised controlled trial to establish whether vv-ECCO2R in acute hypoxaemic respiratory failure can allow the use of a more protective lung ventilation strategy and is associated with improved patient outcomes.

Published
2017
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44. Improving the efficiency of advanced life support training: a randomized, controlled trial.

Author

Perkins GD, Kimani PK, Bullock I, Clutton-Brock T, Davies RP, Gale M, Lam J, Lockey A, Stallard N, Electronic Advanced Life Support Collaborators, Perkins, Gavin D, Kimani, Peter K, Bullock, Ian, Clutton-Brock, Tom, Davies, Robin P, Gale, Mike, Lam, Jenny, Lockey, Andrew, and Stallard, Nigel

Abstract

Background: Each year, more than 1.5 million health care professionals receive advanced life support (ALS) training. Objective: To determine whether a blended approach to ALS training that includes electronic learning (e-learning) produces outcomes similar to those of conventional, instructor-led ALS training. Design: Open-label, noninferiority, randomized trial. Randomization, stratified by site, was generated by Sealed Envelope (Sealed Envelope, London, United Kingdom). (International Standardized Randomized Controlled Trial Number Register: ISCRTN86380392) Setting: 31 ALS centers in the United Kingdom and Australia. Participants: 3732 health care professionals recruited between December 2008 and October 2010. Intervention: A 1-day course supplemented with e-learning versus a conventional 2-day course. Measurements: The primary outcome was performance in a cardiac arrest simulation test at the end of the course. Secondary outcomes comprised knowledge- and skill-based assessments, repeated assessment after remediation training, and resource use. Results: 440 of the 1843 participants randomly assigned to the blended course and 444 of the 1889 participants randomly assigned to conventional training did not attend the courses. Performance in the cardiac arrest simulation test after course attendance was lower in the electronic advanced life support (e-ALS) group compared with the conventional advanced life support (c-ALS) group; 1033 persons (74.5%) in the e-ALS group and 1146 persons (80.2%) in the c-ALS group passed (mean difference, -5.7% [95% CI, -8.8% to -2.7%]). Knowledge- and skill-based assessments were similar between groups, as was the final pass rate after remedial teaching, which was 94.2% in the e-ALS group and 96.7% in the c-ALS group (mean difference, -2.6% [CI, -4.1% to 1.2%]). Faculty, catering, and facility costs were $438 per participant for electronic ALS training and $935 for conventional ALS training. Limitations: Many professionals (24%) did not attend the courses. The effect on patient outcomes was not evaluated. Conclusion: Compared with conventional ALS training, an approach that included e-learning led to a slightly lower pass rate for cardiac arrest simulation tests, similar scores on a knowledge test, and reduced costs. Primary Funding Source: National Institute of Health Research and Resuscitation Council (UK). [ABSTRACT FROM AUTHOR]

Published
2012
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45. Out-of-hospital cardiac arrest: recent advances in resuscitation and effects on outcome.

Author

Perkins GD, Brace SJ, Smythe M, Ong G, and Gates S

Abstract

Successful treatment of out-of-hospital cardiac arrest remains an unmet health need. Key elements of treatment comprise early recognition of cardiac arrest, prompt and effective cardiopulmonary resuscitation (CPR), effective defibrillation strategies and organised post-resuscitation care. The initiation of bystander CPR followed by a prompt emergency response that delivers high quality CPR is critical to outcomes. The integration of additional tasks such as defibrillation, airway management, vascular access and drug administration should avoid interruptions in chest compressions. Evidence for the routine use of CPR prompt/feedback devices, mechanical chest compression devices and pharmacological therapy is limited. [ABSTRACT FROM AUTHOR]

Published
2012

48. European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution.

Author

Soar J, Perkins GD, Abbas G, Alfonzo A, Barelli A, Bierens JJ, Brugger H, Deakin CD, Dunning J, Georgiou M, Handley AJ, Lockey DJ, Paal P, Sandroni C, Thies KC, Zideman DA, and Nolan JP

Published
2010
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50. Vascular endothelial growth factor promotes physical wound repair and is anti-apoptotic in primary distal lung epithelial and A549 cells.

Author

Roberts JR, Perkins GD, Fujisawa T, Pettigrew KA, Gao F, Ahmed A, Thickett DR, Roberts, Jonathan R, Perkins, Gavin D, Fujisawa, Takeshi, Pettigrew, Kerry A, Gao, Fang, Ahmed, Asif, and Thickett, David R

Abstract

Objective: There is evidence to suggest a beneficial role for growth factors, including vascular endothelial growth factor (VEGF), in tissue repair and proliferation after injury within the lung. Whether this effect is mediated predominantly by actions on endothelial cells or epithelial cells is unknown. This study tested the hypothesis that VEGF acts as an autocrine trophic factor for human adult alveolar epithelial cells and that under situations of pro-apoptotic stress, VEGF reduces cell death.Design: In vitro cell culture study looking at the effects of 0.03% H2O2 on both A549 and primary distal lung epithelial cells.Measurement and Main Results: Primary adult human distal lung epithelial cells express both the soluble and membrane-associated VEGF isoforms and VEGF receptors 1 and 2. At physiologically relevant doses, soluble VEGF isoforms stimulate wound repair and have a proliferative action. Specific receptor ligands confirmed that this effect was mediated by VEGF receptor 1. In addition to proliferation, we demonstrate that VEGF reduces A549 and distal lung epithelial cell apoptosis when administered after 0.03% H2O2 injury. This effect occurs due to reduced caspase-3 activation and is phosphatidylinositol 3'-kinase dependent.Conclusion: In addition to its known effects on endothelial cells, VEGF acts as a growth and anti-apoptotic factor on alveolar epithelial cells. VEGF treatment may have potential as a rescue therapy for diseases associated with alveolar epithelial damage such as acute respiratory distress syndrome. [ABSTRACT FROM AUTHOR]

Published
2007
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