Optimizing Ventilation to Improve Survival From Out-of-hospital Cardiac Arrest: the OPTIVO Randomized Controlled Trial
This important study, called OPTIVO, is investigating the best way to help people breathe during CPR after their heart has stopped outside of a hospital. When someone has a cardiac arrest, CPR involves pushing on the chest and helping them breathe. While we know a lot about chest compressions, there's less information on the best way to give breaths. Current guidelines are based on limited evidence. Researchers want to compare two ways of giving air – a 'low volume' and a 'high volume' – to see which is more effective. The goal is to improve how we treat cardiac arrest, helping more people survive and recover well.
At a glance
What is this study about?
Imagine someone's heart suddenly stops beating – this is called a cardiac arrest. When this happens, their body isn't getting enough blood or oxygen. Rescuers often perform Cardiopulmonary Resuscitation (CPR), which involves pressing on the chest to pump blood and giving breaths to provide oxygen. While many years of research have helped us understand the best ways to do chest compressions, there’s actually less information on the best way to give breaths during CPR.
Currently, the advice on how much air to give is based on studies that weren't specifically about cardiac arrest patients. This means doctors and paramedics aren't fully sure if they're giving the right amount of air to help people who have had a cardiac arrest. Giving too little air (hypoventilation) or too much air (hyperventilation) can both be harmful, potentially leading to less oxygen reaching the brain or causing other problems.
This study, called OPTIVO, aims to fill this knowledge gap. Researchers want to find out if giving a specific amount of air – either a slightly smaller amount (low volume) or a slightly larger amount (high volume) – during CPR makes a real difference. By understanding the best way to help patients breathe, this research could lead to better guidelines and ultimately help more people survive cardiac arrest and recover without long-term problems.
Key takeaways
- Heart stops, CPR happens.
- Breathing support is crucial but not perfectly understood.
- This study compares two ways to help patients breathe during CPR.
- Goal is to improve survival and recovery for future cardiac arrest patients.
- Patient participation is during emergency treatment, no extra steps for them.
- Study contributes to better emergency care guidelines.
Who may be eligible?
This study is looking for adults aged 18 or over who experience a cardiac arrest outside of a hospital, where it's thought their heart was the main cause. Paramedics treating these patients would be using a special monitor to track their breathing.
However, some people will not be able to join the study. This includes individuals who have a 'Do Not Resuscitate' order in place, or if their cardiac arrest was caused by an injury (like a car accident), drowning, choking, or drug overdose. Pregnant patients and those who are in prison are also not able to take part.
Crucially, if the paramedics don't use the special breathing monitor, that patient won't be able to be included in the study, even if they meet other criteria.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- Are you 18 years old or older?
- Did the cardiac arrest seem to be caused by a heart problem?
- Were paramedics using a special breathing monitor to assist you?
- Was there no 'Do Not Resuscitate' order in place?
- Was your cardiac arrest not caused by an injury, drowning, choking, or overdose?
What does participation involve?
This study is designed to gather information during an emergency, so patients won’t directly 'take part' in the way you might imagine for a typical clinical trial. Medical teams, like paramedics, will be using specific breathing techniques during CPR based on the study. Patients will not be asked to do anything extra. There are no additional visits, specific medications, or follow-up appointments directly related to the study protocol for the patient. The study will look at patient outcomes, such as survival and recovery after they leave the hospital, to determine if one breathing technique is better than the other. The total duration of individual participation is essentially the period of their emergency care and subsequent hospital admission, with outcomes being tracked later.
Potential risks and benefits
Locations (1)
- Sunnybrook Health Sciences CentreVerified postcodeToronto, Canada
Common questions
What is cardiac arrest?
Cardiac arrest is when your heart suddenly stops beating, meaning blood stops flowing to your brain and other organs. It's a medical emergency.
What is CPR?
CPR stands for Cardiopulmonary Resuscitation. It's an emergency procedure that involves chest compressions and rescue breaths to keep blood and oxygen flowing until medical help arrives.
Why is this study important?
This study is important because it aims to find the best way to help people breathe during CPR, which could save more lives and help people recover better after a cardiac arrest.
Will I know if I or a loved one was part of this study?
In an emergency, consent may not be possible. However, your medical team can provide information about the care received, and researchers will follow strict guidelines for privacy.
What is 'low volume' versus 'high volume' ventilation?
These refer to giving either a slightly smaller or slightly larger amount of air with each breath during CPR. The study will compare which is more effective.
How to find out more
Ian Drennan, PhD
Always speak to your GP or specialist before deciding to take part in a study.
Interested in taking part?
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