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

NCT07679737 | Active Not Recruiting

• 1 other identifier: ANZIC-RC/SR001
• Study Type: observational
• Target: 250
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Extracorporeal Cardiopulmonary Resuscitation; Out of Hospital Cardiac Arrest

Keywords

ECMO; ECPR; Extracorporeal membrane oxygenation; ECMO CPR; at the scene; scene based; OHCA

Outcome Measures

Primary Outcomes (1)

• Survival to hospital discharge

  From meeting full eligibility criteria until the date/time of death or hospital discharge, assessed up to 180 days

Secondary Outcomes (5)

• Low flow time

  time from onset of arrest to time of ECPR flow, or time of death

• ICU length of stay

  From the date/time of ICU admission until the date/time of ICU discharge/death, assessed up to 180 days

• Mechanical ventilation days

  From date/time of mechanical ventilation commencement until date/time of liberation from mechanical ventilation assessed up to 180 days

• ECMO complications

  From the date/time of commencement of ECMO support until 1 week following the date/time of cessation of ECMO support

• Rates of organ and tissue donation in non-survivors

  In the 48hours following date/time of death

Study Arms (2)

Prehospital Extracorporeal Cardiopulmonary Resuscitation (ECPR) Strategy

Patients with refractory OHCA treated with scene-based, pre-hospital ECPR (Intervention) will be identified within two studies testing feasibility of prehospital ECPR for refractory OHCA in the metropolitan regions of Melbourne and Sydney. All intra-arrest and post-arrest care follow guidelines based on the Australian and New Zealand Council of Resuscitation recommendations supplemented by the Victorian ECMO Service (VECMOS) guidelines within Victoria and Agency for Clinical Innovation ECMO Clinical Practice Guidelines in NSW.

Other: Extracorporeal cardiopulmonary resuscitation

Conventional Cardiac Arrest Strategy

Patients with refractory OHCA treated with conventional cardiac arrest strategy (standard care) will be identified within NSW and Victorian Ambulance OHCA Registries. All intra-arrest and post-arrest care for patients in this group follow guidelines based on the Australian and New Zealand Council of Resuscitation recommendations.

Interventions

Extracorporeal cardiopulmonary resuscitation OTHER

The Intervention being evaluated is the initiation of extracorporeal cardiopulmonary resuscitation (ECPR) at the scene, in addition to conventional cardiac arrest care.

Also known as: Extracorporeal Cardiopulmonary Resuscitation (ECPR), Prehospital ECPR, Scene based ECPR

Prehospital Extracorporeal Cardiopulmonary Resuscitation (ECPR) Strategy

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients with refractory out-of-hospital cardiac arrest in the metropolitan regions of Sydney and Melbourne.

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Australian and New Zealand Intensive Care Research Centre: lead

Study Sites (1)

Monash University

Melbourne, Victoria, Australia

Location

MeSH Terms

Conditions

Out-of-Hospital Cardiac Arrest

Condition Hierarchy (Ancestors)

Heart Arrest; Heart Diseases; Cardiovascular Diseases

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 9, 2026
• First Posted: July 1, 2026
• Study Start: January 1, 2025
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026
• Last Updated: July 1, 2026

Record last verified: 2026-06

Locations

AU (1)