Design of the RINSE trial: The rapid infusion of cold normal saline by paramedics during CPR

Background: The International Liaison Committee on Resuscitation (ILCOR) now recommends therapeutic hypothermia (TH) (33°C for 12-24 hours) as soon as possible for patients who remain comatose after resuscitation from shockable rhythm in out-of-hospital cardiac arrest and that it be considered for n...

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Main Authors: Deasy, C., Bernard, S., Cameron, P., Jacobs, Ian, Smith, K., Hein, C., Grantham, H., Finn, Judith
Format: Journal Article
Published: BioMed Central Ltd. 2011
Online Access:http://hdl.handle.net/20.500.11937/5120
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author Deasy, C.
Bernard, S.
Cameron, P.
Jacobs, Ian
Smith, K.
Hein, C.
Grantham, H.
Finn, Judith
author_facet Deasy, C.
Bernard, S.
Cameron, P.
Jacobs, Ian
Smith, K.
Hein, C.
Grantham, H.
Finn, Judith
author_sort Deasy, C.
building Curtin Institutional Repository
collection Online Access
description Background: The International Liaison Committee on Resuscitation (ILCOR) now recommends therapeutic hypothermia (TH) (33°C for 12-24 hours) as soon as possible for patients who remain comatose after resuscitation from shockable rhythm in out-of-hospital cardiac arrest and that it be considered for non shockable rhythms. The optimal timing of TH is still uncertain. Laboratory data have suggested that there is significantly decreased neurological injury if cooling is initiated during CPR. In addition, peri-arrest cooling may increase the rate of successful defibrillation. This study aims to determine whether paramedic cooling during CPR improves outcome compared standard treatment in patients who are being resuscitated from out-of-hospital cardiac arrest. Methods/Design:This paper describes the methodology for a definitive multi-centre, randomised, controlled trial of paramedic cooling during CPR compared with standard treatment. Paramedic cooling during CPR will be achieved using a rapid infusion of large volume (20-40 mL/kg to a maximum of 2 litres) ice-cold (4°C) normal saline. The primary outcome measure is survival at hospital discharge. Secondary outcome measures are rates of return of spontaneous circulation, rate of survival to hospital admission, temperature on arrival at hospital, and 12 month quality of life of survivors. Discussion: This trial will test the effect of the administration of ice cold saline during CPR on survival outcomes. If this simple treatment is found to improve outcomes, it will have generalisability to prehospital services globally.
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spelling curtin-20.500.11937-51202017-09-13T14:43:28Z Design of the RINSE trial: The rapid infusion of cold normal saline by paramedics during CPR Deasy, C. Bernard, S. Cameron, P. Jacobs, Ian Smith, K. Hein, C. Grantham, H. Finn, Judith Background: The International Liaison Committee on Resuscitation (ILCOR) now recommends therapeutic hypothermia (TH) (33°C for 12-24 hours) as soon as possible for patients who remain comatose after resuscitation from shockable rhythm in out-of-hospital cardiac arrest and that it be considered for non shockable rhythms. The optimal timing of TH is still uncertain. Laboratory data have suggested that there is significantly decreased neurological injury if cooling is initiated during CPR. In addition, peri-arrest cooling may increase the rate of successful defibrillation. This study aims to determine whether paramedic cooling during CPR improves outcome compared standard treatment in patients who are being resuscitated from out-of-hospital cardiac arrest. Methods/Design:This paper describes the methodology for a definitive multi-centre, randomised, controlled trial of paramedic cooling during CPR compared with standard treatment. Paramedic cooling during CPR will be achieved using a rapid infusion of large volume (20-40 mL/kg to a maximum of 2 litres) ice-cold (4°C) normal saline. The primary outcome measure is survival at hospital discharge. Secondary outcome measures are rates of return of spontaneous circulation, rate of survival to hospital admission, temperature on arrival at hospital, and 12 month quality of life of survivors. Discussion: This trial will test the effect of the administration of ice cold saline during CPR on survival outcomes. If this simple treatment is found to improve outcomes, it will have generalisability to prehospital services globally. 2011 Journal Article http://hdl.handle.net/20.500.11937/5120 10.1186/1471-227X-11-17 BioMed Central Ltd. fulltext
spellingShingle Deasy, C.
Bernard, S.
Cameron, P.
Jacobs, Ian
Smith, K.
Hein, C.
Grantham, H.
Finn, Judith
Design of the RINSE trial: The rapid infusion of cold normal saline by paramedics during CPR
title Design of the RINSE trial: The rapid infusion of cold normal saline by paramedics during CPR
title_full Design of the RINSE trial: The rapid infusion of cold normal saline by paramedics during CPR
title_fullStr Design of the RINSE trial: The rapid infusion of cold normal saline by paramedics during CPR
title_full_unstemmed Design of the RINSE trial: The rapid infusion of cold normal saline by paramedics during CPR
title_short Design of the RINSE trial: The rapid infusion of cold normal saline by paramedics during CPR
title_sort design of the rinse trial: the rapid infusion of cold normal saline by paramedics during cpr
url http://hdl.handle.net/20.500.11937/5120