Parenteral medications have been an integral part of Advanced Cardiac Life Support (ACLS) treatment of ventricular fibrillation out-of-hospital cardiac arrest since 1974. In over four decades of study, none of the recommended ACLS resuscitation drugs have ever been shown to impact long-term, patient-oriented outcomes. Through this original research using a clinically applicable swine model of prolonged ventricular fibrillation cardiac arrest, we seek to evaluate a novel medication combination designed to improve pre- and post-resuscitation cellular energetics. We hypothesize that this completely new approach - providing glucose-insulin-potassium during reperfusion after prolonged ventricular fibrillation cardiac arrest - will improve myocardial energy metabolism and restore ventricular fibrillation to a shockable morphology more promptly. This will increase the probability of defibrillation success and the likelihood of return of spontaneous circulation leading to a reduction in post arrest myocardial dysfunction and an opportunity for more favorable neurological outcome. This work is innovative in that we are not simply refining an existing paradigm, but rather challenging and redefining the entire conceptual framework of ventricular fibrillation out-of-hospital cardiac arrest ACLS drug treatment. Recent improvements to ventricular fibrillation out-of-hospital cardiac arrest resuscitation processes have exposed drug therapy as a weak link in the American Heart Association ACLS chain of survival. Strengthening this link with a replacement drug combination will be a major discovery and advance in the field of cardiovascular research, will have powerful and sustained influence on future research in this field, and have profound impact on integrated post-cardiac arrest patient care. Before we can move forward and confidently evaluate additional resuscitation process alternatives and adjuncts to further improve neurologically intact patient survival, we must develop a new resuscitation drug combination that will expedite return of spontaneous circulation and reduce post arrest myocardial dysfunction. This work is expected to immediately transition to phase II and III clinical trials and will ultimately lead to improvement in meaningful long-term patient-oriented outcomes, thereby supporting the American Heart Association mission of building healthier lives, free of cardiovascular and neurological disability.
|Program type||Innovative Project Award|
|Effective start/end date||07/01/2018 → 06/30/2020|