Optimal Ventilation for Cardiac Arrest
OPTImal Ventilation to Improve Pediatric Cardiac Arrest Outcomes (OPTI-VENT)
Children's Hospital of Philadelphia
1,530 participants
Oct 1, 2025
INTERVENTIONAL
Conditions
Summary
Pediatric cardiac arrest is a life-threatening problem affecting \>15,000 hospitalized children each year. Less than half of these children survive to hospital discharge, and neurologic morbidity is common among survivors. The objective of this study is to evaluate the effectiveness of the OPTI-VENT bundle to improve survival to discharge with favorable neurological outcome (Pediatric Cerebral Performance Category Score 1-2 or no change from baseline) among children receiving at least 1 minute of CPR.
Eligibility
Inclusion Criteria2
- Invasive airway in place at the start of CPR or airway placed within the first 5 minutes
- Received at least 1 minute of CPR.
Exclusion Criteria4
- Lack of commitment to aggressive ICU therapies (e.g., CPR performed as part of end-of-life care.
- Brain death determination prior to the CPR event.
- Out-of-hospital cardiac arrest was the reason for initial admission to the hospital (known poor outcomes).
- Supported by Veno-Arterial Extra Corporeal Membrane Oxygenation at the start of CPR
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Interventions
Provider Education: During a brief (\<2 minute) bedside education, the educator will 1) review the CPR ventilation rate targets for age, and 2) ensure the provider has a cue card of current rate recommendations on his/her person. Compliance will be defined as performance of at least 30 trainings per unit per month. We will record provider discipline and time since last training as a surrogate of training spread. Educators will leverage these two-minute trainings to review the patient's current ventilator settings as an initial target during CPR to ensure adequate chest rise. Additionally, a focus on CPR ventilation rates will be integrated into resuscitation education or quality meetings for all disciplines. "Report cards" detailing unit-level performance will be generated by the study team for review during site monthly presentations. Point-of-Care Guidance: A metronome will be deployed to all cardiac arrests using a smart phone application.
There will be a 2-month transition period for study sites beginning study enrollment using standard ICU practices as they onboard to the study intervention.
Control - no intervention
Locations(20)
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NCT07114510