The CPR, Pre-hospital ECPR and Early Reperfusion Study: A Target Trial Emulation

CHEER4TTE is a target trial emulation, designed to simulate a randomised controlled trial by utilising data from pre-existing data sources. The aim is to determine whether prehospital ECPR for refractory out-of-hospital cardiac arrest improves the rate of survival to hospital discharge when compared to conventional cardiac arrest care.

Inclusion Criteria: * Witnessed cardiac arrest * Bystander CPR * Refractory cardiac arrest (failure to achieve sustained ROSC \>20 minutes) * Initial cardiac rhythm VF, VT or PEA * Within the hours of prehospital ECPR service operation Exclusion Criteria: * Initial cardiac rhythm asystole * ROSC with sustained recovery * Unable to reach the patient and commence cannulation within 45 minutes of onset of arrest * Evidence of/suspected end-stage disease: * severe disability impairing activities of daily living * end-stage organ disease - cardiac, liver, lung, renal * other life-limiting diseases, e.g. malignancy, terminal illness * advance health care directive * Time periods of advanced public health restrictions in Victoria and NSW due to COVID-19