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Emergency Preservation and Resuscitation

Tue, 11/15/2011

Recognizing that trauma patients who suffer a cardiac arrest have a <10% chance of survival, even if their injuries are technically repairable, Dr. Peter Safar and Colonel Ron Bellamy proposed over 20 years ago that rapid induction of hypothermia could “buy time” for the trauma surgical team to control bleeding. Systematic studies at the Safar Center for Resuscitation Research under the direction of Drs. Safar, Sam Tisherman, and Pat Kochanek have utilized animal studies to demonstrate the feasibility of inducing profound hypothermia (50oF) to provide a prolonged period of cardiac arrest after exsanguinating hemorrhage.

Dr. Tisherman is now leading the Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma (EPR-CAT) Study, sponsored by the U.S. Department of Defense, and coordinated by the University of Pittsburgh and UPMC, as a feasibility and safety study designed to see if hypothermia may be beneficial in this setting. In EPR, body temperature is lowered to about 50oF by administering a large volume of cold fluid through a large tube, called a cannula, placed into the aorta, which is the largest artery in the body. A heart-lung bypass machine would be used to restore blood circulation and oxygenation as part of the resuscitation process. The study will also be conducted at the University of Maryland.

Because patients to be enrolled in this study will be unable to give informed consent, this study will be conducted under the federally regulated exception-from-informed consent process, which includes appropriate community consultation and public notification. More information about the study can be obtained at acutecareresearch.org

A brief interview with Dr. Tisherman and a simulation of the EPR-CAT protocol is available here.

Dr. Tisherman and co-investigator Dr. Patrick Kochanek have a financial interest in intellectual property for the development of the emergency preservation and resuscitation (EPR) procedure and some of the associated equipment, including special catheters and accessories that have been licensed to EPR Technologies. It is possible that study results could lead to personal profit for the individual investigators and the University of Pittsburgh.  For more information regarding the conflict-of-interest management plan for this study, contact Dr. Raquel Forsythe at 412-647-1158 or the Human Subject Protection Advocate, University of Pittsburgh, at 866-212-2668.