Cluster randomised comparison of the effectiveness of 100 percent oxygen versus titrated oxygen:

In patients with a sustained return of spontaneous circulation following out of hospital cardiac arrest

Summary

Emergency general surgery (EGS) is a term used to describe a broad range of conditions. The commonest include problems with the large and small bowel, appendix, pancreas, gallbladder and hernias and abscesses. It does not include trauma surgery. Following successful resuscitation from a cardiac arrest, ambulance services have traditionally used 100% oxygen. There is evidence that 100% oxygen can be harmful to humans. This has been seen in patients with strokes and heart attacks as well as resuscitation of newborn babies. This application is for sufficient time to prepare, plan, write and submit a high quality application for funding to complete a research study that will compare the patient outcomes achieved by two groups of paramedics. One group will use 100% oxygen as they do now. The other group will reduce the oxygen that is delivered towards normal, whilst measuring the patient's oxygen level using a saturation probe. We will follow up all enrolled patients and measure survival and neuron specific enolase (NSE), an accepted marker of brain damage, to determine which approach achieves the best patient outcome. We will also measure a number of secondary outcomes of health and wellbeing and collect data that will allow the relative cost effectiveness of the two approaches to be determined. This study follows a successful feasibility study and an approach that has been established in other similar studies, including active patient and public participation.