The survival from out of hospital cardiac arrest varies from region to region. This makers sense as it depends on resources, such as medical and nursing staff, expertise of that staff and resources available to them. it also depends on the infrastructure which includes the timely response of emergency services and the rapid delivery of patients to a centre that can provide advanced resuscitation and post arrest care including cardiac reperfusion and intensive care management. (12 minutes reading)
We know that immediate coronary angiography in post OHCA patients with no ST elevation provides no survival benefit (1-3). But does the transfer of patients without ST elevation OHCA, to a cardiac arrest centre rather than a standard care hospital result in better survival and neurological outcomes?
A previous Meta-analysis (4) has shown that treatment in a cardiac arrest centre resulted in improved survival and neurological outcome. This was based mostly on observational data, with potential inherited biases.. The ARREST Trial(5) is the first randomised trial to look at this question.
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