Hospital Airway Resuscitation Trial: A Cluster-Randomized, Pragmatic Trial
Montefiore Medical Center
Summary
The Hospital Airway Resuscitation Trial (HART) is a cluster-randomized, pragmatic trial of advanced airway management with a strategy of first choice supraglottic airway vs. first choice endotracheal intubation during in-hospital cardiac arrest.
Description
In-hospital cardiac arrest occurs in nearly 300,000 hospitalized patients in the United States each year and results in substantial morbidity and mortality. Nevertheless, the evidence base guiding the management of in-hospital cardiac arrest is quite limited and society guidelines generally extrapolate data from the out-of-hospital cardiac setting to inform in-hospital arrest care. As compared to out-of-hospital arrest, however, in-hospital arrest victims tend to have more medical comorbidities, have a witnessed arrest, and be attended to by professional first responders with advanced monitori…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Adult aged \>=18 years 2. Admitted to the hospital for any condition 3. Suffered in-hospital cardiac arrest (loss of pulse and ≥2 minutes of chest compressions) 4. Need for assisted ventilation (defined by initiation of bag-mask-ventilation or other supported ventilation) Exclusion Criteria: 1. Cardiac arrest in the Operating Room or other area not responded to by Critical Care/Emergency Department (ED) teams. 2. Cardiac arrest in which an invasive airway (i.e. endotracheal tube, tracheostomy tube) is already in place 3. Patients with Do Not Resuscitate or Do Not Intu…
Interventions
- ProcedureA strategy of first choice supraglottic airway
See description in Arms section
- ProcedureA strategy of first choice endotracheal intubation
See description in Arms section
Location
- Montefiore Medical CenterNew York, New York