Early initiation of extracorporeal life support in refractory out-of-hospital cardiac arrest: Design and rationale of the INCEPTION trial

Martine E. Bol; Martje M. Suverein; Roberto Lorusso; Thijs S. R. Delnoij; George J. Brandon Bravo Bruinsma; Luuk Otterspoor; Marijn Kuijpers; Ka Yan Lam; Alexander P. J. Vlaar; Carlos V. Elzo Kraemer; Joris J. van der Heijden; Erik Scholten; Antoine H. G. Driessen; Jose M. Montero Cabezas; Saskia Z. H. Rittersma; Bram G. Heijnen; Fabio S. Taccone; Brigitte Essers; Tammo Delhaas; Patrick W. Weerwind; Paul M. H. J. Roekaerts; Jos G. Maessen; Marcel C. G. van de Poll

doi:10.1016/j.ahj.2018.12.008

Early initiation of extracorporeal life support in refractory out-of-hospital cardiac arrest: Design and rationale of the INCEPTION trial

Martine E. Bol, Martje M. Suverein^*, Roberto Lorusso, Thijs S. R. Delnoij, George J. Brandon Bravo Bruinsma, Luuk Otterspoor, Marijn Kuijpers, Ka Yan Lam, Alexander P. J. Vlaar, Carlos V. Elzo Kraemer, Joris J. van der Heijden, Erik Scholten, Antoine H. G. Driessen, Jose M. Montero Cabezas, Saskia Z. H. Rittersma, Bram G. Heijnen, Fabio S. Taccone, Brigitte Essers, Tammo Delhaas, Patrick W. WeerwindPaul M. H. J. Roekaerts, Jos G. Maessen, Marcel C. G. van de Poll

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

23 Citations (Web of Science)

Abstract

Background Return of spontaneous circulation occurs in less than 10% of patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR) for more than 15 minutes. Studies suggest that extracorporeal life support during cardiopulmonary resuscitation (ECPR) improves survival rate in these patients. These studies, however, are hampered by their non-randomized, observational design and are mostly single-center. A multicenter, randomized controlled trial is urgently warranted to evaluate the effectiveness of ECPR.

Hypothesis We hypothesize that early initiation of ECPR in refractory out-of-hospital cardiac arrest (OHCA) improves the survival rate with favorable neurological status.

Study design The INCEPTION trial is an investigator-initiated, prospective, multicenter trial that will randomly allocate 110 patients to either continued CPR or ECPR in a 1: 1 ratio. Patients eligible for inclusion are adults (

Summary The INCEPTION trial aims to determine the clinical benefit for the use of ECPR in patients with refractory OHCA presenting with VF/VT. Additionally, the feasibility and cost-effectiveness of ECPR will be evaluated.

Original language	English
Pages (from-to)	58-68
Number of pages	11
Journal	American Heart Journal
Volume	210
DOIs	https://doi.org/10.1016/j.ahj.2018.12.008
Publication status	Published - Apr 2019

Keywords

CONVENTIONAL CARDIOPULMONARY-RESUSCITATION
COUNCIL GUIDELINES
DEFERRED CONSENT
CARE
SURVIVAL
ADULTS

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Bol, M. E., Suverein, M. M., Lorusso, R., Delnoij, T. S. R., Bruinsma, G. J. B. B., Otterspoor, L., Kuijpers, M., Lam, K. Y., Vlaar, A. P. J., Kraemer, C. V. E., van der Heijden, J. J., Scholten, E., Driessen, A. H. G., Cabezas, J. M. M., Rittersma, S. Z. H., Heijnen, B. G., Taccone, F. S., Essers, B., Delhaas, T., ... van de Poll, M. C. G. (2019). Early initiation of extracorporeal life support in refractory out-of-hospital cardiac arrest: Design and rationale of the INCEPTION trial. American Heart Journal, 210, 58-68. https://doi.org/10.1016/j.ahj.2018.12.008

@article{8b4a5ddabe6b4202ab7fa2e33fb67d2a,

title = "Early initiation of extracorporeal life support in refractory out-of-hospital cardiac arrest: Design and rationale of the INCEPTION trial",

abstract = "Background Return of spontaneous circulation occurs in less than 10% of patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR) for more than 15 minutes. Studies suggest that extracorporeal life support during cardiopulmonary resuscitation (ECPR) improves survival rate in these patients. These studies, however, are hampered by their non-randomized, observational design and are mostly single-center. A multicenter, randomized controlled trial is urgently warranted to evaluate the effectiveness of ECPR.Hypothesis We hypothesize that early initiation of ECPR in refractory out-of-hospital cardiac arrest (OHCA) improves the survival rate with favorable neurological status.Study design The INCEPTION trial is an investigator-initiated, prospective, multicenter trial that will randomly allocate 110 patients to either continued CPR or ECPR in a 1: 1 ratio. Patients eligible for inclusion are adults (Summary The INCEPTION trial aims to determine the clinical benefit for the use of ECPR in patients with refractory OHCA presenting with VF/VT. Additionally, the feasibility and cost-effectiveness of ECPR will be evaluated.",

keywords = "CONVENTIONAL CARDIOPULMONARY-RESUSCITATION, COUNCIL GUIDELINES, DEFERRED CONSENT, CARE, SURVIVAL, ADULTS",

author = "Bol, {Martine E.} and Suverein, {Martje M.} and Roberto Lorusso and Delnoij, {Thijs S. R.} and Bruinsma, {George J. Brandon Bravo} and Luuk Otterspoor and Marijn Kuijpers and Lam, {Ka Yan} and Vlaar, {Alexander P. J.} and Kraemer, {Carlos V. Elzo} and {van der Heijden}, {Joris J.} and Erik Scholten and Driessen, {Antoine H. G.} and Cabezas, {Jose M. Montero} and Rittersma, {Saskia Z. H.} and Heijnen, {Bram G.} and Taccone, {Fabio S.} and Brigitte Essers and Tammo Delhaas and Weerwind, {Patrick W.} and Roekaerts, {Paul M. H. J.} and Maessen, {Jos G.} and {van de Poll}, {Marcel C. G.}",

year = "2019",

month = apr,

doi = "10.1016/j.ahj.2018.12.008",

language = "English",

volume = "210",

pages = "58--68",

journal = "American Heart Journal",

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Bol, ME, Suverein, MM , Lorusso, R , Delnoij, TSR, Bruinsma, GJBB, Otterspoor, L, Kuijpers, M, Lam, KY, Vlaar, APJ, Kraemer, CVE, van der Heijden, JJ, Scholten, E, Driessen, AHG, Cabezas, JMM, Rittersma, SZH, Heijnen, BG, Taccone, FS, Essers, B , Delhaas, T , Weerwind, PW , Roekaerts, PMHJ , Maessen, JG & van de Poll, MCG 2019, 'Early initiation of extracorporeal life support in refractory out-of-hospital cardiac arrest: Design and rationale of the INCEPTION trial', American Heart Journal, vol. 210, pp. 58-68. https://doi.org/10.1016/j.ahj.2018.12.008

TY - JOUR

T1 - Early initiation of extracorporeal life support in refractory out-of-hospital cardiac arrest

T2 - Design and rationale of the INCEPTION trial

AU - Bol, Martine E.

AU - Suverein, Martje M.

AU - Lorusso, Roberto

AU - Delnoij, Thijs S. R.

AU - Bruinsma, George J. Brandon Bravo

AU - Otterspoor, Luuk

AU - Kuijpers, Marijn

AU - Lam, Ka Yan

AU - Vlaar, Alexander P. J.

AU - Kraemer, Carlos V. Elzo

AU - van der Heijden, Joris J.

AU - Scholten, Erik

AU - Driessen, Antoine H. G.

AU - Cabezas, Jose M. Montero

AU - Rittersma, Saskia Z. H.

AU - Heijnen, Bram G.

AU - Taccone, Fabio S.

AU - Essers, Brigitte

AU - Delhaas, Tammo

AU - Weerwind, Patrick W.

AU - Roekaerts, Paul M. H. J.

AU - Maessen, Jos G.

AU - van de Poll, Marcel C. G.

PY - 2019/4

Y1 - 2019/4

N2 - Background Return of spontaneous circulation occurs in less than 10% of patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR) for more than 15 minutes. Studies suggest that extracorporeal life support during cardiopulmonary resuscitation (ECPR) improves survival rate in these patients. These studies, however, are hampered by their non-randomized, observational design and are mostly single-center. A multicenter, randomized controlled trial is urgently warranted to evaluate the effectiveness of ECPR.Hypothesis We hypothesize that early initiation of ECPR in refractory out-of-hospital cardiac arrest (OHCA) improves the survival rate with favorable neurological status.Study design The INCEPTION trial is an investigator-initiated, prospective, multicenter trial that will randomly allocate 110 patients to either continued CPR or ECPR in a 1: 1 ratio. Patients eligible for inclusion are adults (Summary The INCEPTION trial aims to determine the clinical benefit for the use of ECPR in patients with refractory OHCA presenting with VF/VT. Additionally, the feasibility and cost-effectiveness of ECPR will be evaluated.

AB - Background Return of spontaneous circulation occurs in less than 10% of patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR) for more than 15 minutes. Studies suggest that extracorporeal life support during cardiopulmonary resuscitation (ECPR) improves survival rate in these patients. These studies, however, are hampered by their non-randomized, observational design and are mostly single-center. A multicenter, randomized controlled trial is urgently warranted to evaluate the effectiveness of ECPR.Hypothesis We hypothesize that early initiation of ECPR in refractory out-of-hospital cardiac arrest (OHCA) improves the survival rate with favorable neurological status.Study design The INCEPTION trial is an investigator-initiated, prospective, multicenter trial that will randomly allocate 110 patients to either continued CPR or ECPR in a 1: 1 ratio. Patients eligible for inclusion are adults (Summary The INCEPTION trial aims to determine the clinical benefit for the use of ECPR in patients with refractory OHCA presenting with VF/VT. Additionally, the feasibility and cost-effectiveness of ECPR will be evaluated.

KW - CONVENTIONAL CARDIOPULMONARY-RESUSCITATION

KW - COUNCIL GUIDELINES

KW - DEFERRED CONSENT

KW - CARE

KW - SURVIVAL

KW - ADULTS

U2 - 10.1016/j.ahj.2018.12.008

DO - 10.1016/j.ahj.2018.12.008

M3 - Article

C2 - 30738245

VL - 210

SP - 58

EP - 68

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

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