Cardiac resuscitation trial at St. Paul’s Hospital the first of its kind in Canada

Jul 14, 2016 | News

St. Paul’s Hospital and BC Emergency Health Services (BCEHS) are conducting a landmark trial that could increase the survival rate of seemingly healthy people who suffer a sudden cardiac arrest outside of a hospital setting.

The trial is called BC Extracorporeal Cardiopulmonary Resuscitation Trial for Refractory Out of Hospital Cardiac (ECPR) and is the first of its kind in Canada. It involves a rapid, coordinated response by both paramedics and a cardio team at St. Paul’s Hospital.

Thirty advanced-care paramedics in Vancouver and the North Shore have been trained to recognize, care for and quickly transport patients who meet pre-established criteria to St. Paul’s Hospital. The protocol focuses on patients who would be most likely to benefit: previously healthy and relatively young persons with sudden cardiac arrest who receive rapid CPR before arrival at the hospital.

In the trial, paramedics attach a portable, automatic chest-compression system to a patient who has suffered cardiac arrest to provide continuous, high-quality compressions while being transported in the ambulance. CPR cannot be effectively or safely delivered in a moving vehicle. Using the automatic machine allows paramedics to focus on providing advanced cardiac care, monitoring the patient and getting to the hospital quickly.

Upon arrival at St. Paul’s, the patient is met by a hospital–based team that initiatives a life-saving therapy called ECMO-CPR (Extracorporeal Membrane Oxygenation – Cardiopulmonary Resuscitation). The team attaches the patient to the ECMO machine, an external pump that does the job of a patient’s heart and lungs, while doctors work to fix what caused the arrest.

The goal is to get the patient to St. Paul’s Hospital and started on ECMO within 60 minutes of first responders initially administering CPR.

“St. Paul’s extensive experience in advanced innovative cardiac therapies, in partnership with BCEHS’s renowned track record in pre-hospital resuscitation, gives this cutting-edge program great potential to improve the survival rates of cardiac-arrest patients,” says Dr. Brian Grunau, BC ECPR Study Principle Investigator, Department of Emergency Medicine at St. Paul’s Hospital.

“This promising trial could help save precious lives thanks to the close collaboration, innovative research and patient-focused approach of our hospital and pre-hospital care teams,” says BC Health Minister Terry Lake.  

This protocol has already saved the lives of several patients with cardiac arrest, including Vancouver media and IT manager Genya Kaplun. His girlfriend found him unresponsive on his apartment balcony in February 2014, at age 38. He was in full-blown cardiac arrest. He was taken to St. Paul’s Hospital and was revived with ECPR.

The trial is expected to last two years. Funding came from a number of sources, including Providence Health Care Research Institute. U.S. medical-devices company Physio-Control Inc. has provided vital equipment for the trial.

QUICK FACTS:

  • Cardiac arrest is among the leading causes of death in BC and across Canada.
  • In 2015, paramedics responded to 627 suspected cardiac arrests in Vancouver and North Vancouver.
  • Only about 14 per cent of patients survive out of hospital cardiac arrests.
  • Researchers hope to eventually triple that survival rate using this new therapy.

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