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Trial registered on ANZCTR
Registration number
ACTRN12619000303145
Ethics application status
Approved
Date submitted
12/02/2019
Date registered
27/02/2019
Date last updated
8/11/2021
Date data sharing statement initially provided
27/02/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
A pilot study of patients in cardiac arrest utilising a heart-lung bypass machine prior to transport to hospital to improve survival rates.
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Scientific title
CPR, pre-Hospital ECMO and Early Reperfusion (CHEER 3 Trial) for patients in refractory cardiac arrest to improve survival to hospital discharge.
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Secondary ID [1]
297366
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None
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Universal Trial Number (UTN)
U1111-1228-3535
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Trial acronym
CHEER 3
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Linked study record
NCT01186614 (CHEER). CHEER 3 is a follow-up study to NCT01186614.
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Health condition
Health condition(s) or problem(s) studied:
Cardiac Arrest
311501
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Coronary heart disease
311502
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Condition category
Condition code
Cardiovascular
310137
310137
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
All patients enrolled in the trial will undergo CPR at the scene prior to and after enrolment into the trial until ECMO is functioning. All enrolled patients will have ECMO attempted and if successful, these patients will then be transported to hospital for further management including transfer to the catheterisation lab if appropriate. Both pre-hospital ambulance care records and Alfred Hospital records will be reviewed by investigators for compliance, to identify any problems and for data collection.
Treatment: Device - Extracorporeal Membrane Oxygenation (ECMO)
Insertion of peripheral veno-arterial ECMO at scene of cardiac arrest by ECMO team including two Intensive Care Consultants
Treatment: Cardiopulmonary Resuscitation (CPR)
CPR will be given to the patient until ECMO has been implemented.
Treatment: Early Reperfusion
Once the patient has been transported to hospital, they will be taken directly to the Catheterisation Lab if appropriate.
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Intervention code [1]
313620
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Treatment: Devices
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Survival to hospital discharge through data linkage to hospital medical records.
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Assessment method [1]
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Timepoint [1]
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At hospital discharge
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Primary outcome [2]
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Neurological recovery using Cerebral Performance Category score
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Assessment method [2]
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Timepoint [2]
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At hospital discharge
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Secondary outcome [1]
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ECMO cannulation time using data recorded in the Ambulance Patient Care Records
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Assessment method [1]
366756
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Timepoint [1]
366756
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On admission
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Secondary outcome [2]
366757
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ICU length of stay using hospital medical records
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Assessment method [2]
366757
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Timepoint [2]
366757
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At hospital discharge
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Secondary outcome [3]
366759
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Mechanical ventilation days using hospital medical records
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Assessment method [3]
366759
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Timepoint [3]
366759
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At hospital discharge
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Secondary outcome [4]
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Complications of ECMO using hospital medical records. These include mechanical complications with equipment, haemorrhage, neurological complications, renal impairment, pneumothorax, tamponade, infection and metabolic complications.
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Assessment method [4]
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Timepoint [4]
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At hospital discharge
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Secondary outcome [5]
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ECMO Success Rate obtained from Ambulance and Hospital medical records
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Assessment method [5]
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Timepoint [5]
367106
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On admission
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Eligibility
Key inclusion criteria
Age 18 to 65 years
Witnessed cardiac arrest (bystander or paramedic)
Time from arrest to commence chest compressions of less than 5 minutes
Duration of cardiac arrest between 20 and 45 minutes
Initial cardiac rhythm of Ventricular Fibrillation/pulseless Ventricular Tachycardia/Pulseless Electrical Activity
In cardiac arrest on arrival of ECMO team
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Traumatic arrest including hanging
Known to have significant life-limiting co-morbidities (eg COPD/cirrhosis/dementia) or terminal illness
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
As a feasibility study, this project plans to enrol 25 patients over a 12 month period.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/03/2021
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Actual
28/04/2021
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Date of last participant enrolment
Anticipated
30/06/2022
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Actual
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Date of last data collection
Anticipated
31/07/2022
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Actual
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Sample size
Target
25
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Accrual to date
3
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
13089
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The Alfred - Prahran
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Recruitment postcode(s) [1]
25598
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3004 - Prahran
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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The Alfred Foundation
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Address [1]
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55 Commercial Road, Melbourne VIC 3004
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Country [1]
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Australia
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Funding source category [2]
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Government body
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Name [2]
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Ambulance Victoria
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Address [2]
301934
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375 Manningham Road, Doncaster VIC 3108
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Country [2]
301934
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Australia
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Primary sponsor type
Government body
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Name
Ambulance Victoria
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Address
375 Manningham Road, Doncaster VIC 3108
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Country
Australia
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Secondary sponsor category [1]
301689
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Hospital
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Name [1]
301689
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The Alfred Hospital
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Address [1]
301689
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55 Commercial Road, Melbourne VIC 3004
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Country [1]
301689
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302616
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Alfred HREC
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Ethics committee address [1]
302616
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PO Box 315 Prahran VIC 3181
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Ethics committee country [1]
302616
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Australia
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Date submitted for ethics approval [1]
302616
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15/01/2019
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Approval date [1]
302616
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30/09/2019
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Ethics approval number [1]
302616
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HREC/46089/Alfred-2018
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Summary
Brief summary
The CHEER 3 Trial is a treatment strategy aimed at providing hope for patients who are otherwise very likely to die. In patients who suffer cardiac arrest, a range of interventions such as CPR, defibrillation and injection of drugs are provided at the scene by paramedics to attempt to restart the heart. If paramedics are unsuccessful, there is very little hope of recovery and the patient is usually declared deceased at scene. Transport to hospital with CPR may be attempted but previous research indicates this is usually unsuccessful due to the time taken to arrive at hospital for further treatments. This trial will evaluate an alternative approach involving doctors from The Alfred Hospital being transported to the scene and placing the patient on a heart-lung machine called ECMO. Once stabilised on ECMO, the patient will then be taken to the Alfred Hospital for further investigations and treatment.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Stephen Bernard
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Address
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Ambulance Victoria
PO Box 2000
Doncaster VIC 3108
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Country
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Australia
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Phone
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+61 398403500
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Fax
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Email
90830
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[email protected]
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Contact person for public queries
Name
90831
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Stephen Bernard
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Address
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Ambulance Victoria
PO Box 2000
Doncaster VIC 3108
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Country
90831
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Australia
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Phone
90831
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+61 398403500
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Fax
90831
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Email
90831
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[email protected]
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Contact person for scientific queries
Name
90832
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Stephen Bernard
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Address
90832
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Ambulance Victoria
PO Box 2000
Doncaster VIC 3108
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Country
90832
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Australia
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Phone
90832
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+61 398403500
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Fax
90832
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Email
90832
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Requests for access to trial data will be considered if required.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Prehospital Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis.
2023
https://dx.doi.org/10.1053/j.jvca.2022.12.004
Embase
Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest in Australia: a narrative review.
2024
https://dx.doi.org/10.5694/mja2.52130
N.B. These documents automatically identified may not have been verified by the study sponsor.
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