The Resuscitation Outcomes Consortium (ROC), consisting of 9 Regional Clinical Centers and a Data and Coordinating Center, is conducting multiple collaborative trials to achieve its long-term objective of rapid translation of promising scientific and clinical advances to improve resuscitation outcomes in the out-of hospital setting. Having established unprecedented infrastructure to successfully accomplish this goal (using exception from informed consent under emergency circumstances) in 245 EMS agencies and nearly 35,000 EMS providers covering a population of over 22 million people throughout North America, ROC has already demonstrated its ability to rapidly advance the fields of emergency cardiac and trauma care. This proposal presents the rationale for a 6-year renewal of funding for ROC to continue to improve outcomes for these important national healthcare issues. Three of the specific aims of the Consortium are to further advance these fields by: 1) continuing to expand and investigate the cardiac arrest and traumatic injury Epistry database (already the largest available resource of its kind in the world), 2) complete ongoing cardiac arrest and traumatic injury studies in the next 18 months, and 3) implement and complete multiple additional cardiac arrest and traumatic injury clinical trials. The scientifically most premising trauma interventions, targeted for completion during the renewal period include, 1) immediate versus delayed intravenous fluid to decrease hemorrhage and subsequent reperfusion injury, 2) intravenous estrogen to decrease the magnitude of reperfusion injury, and 3) intravenous pentoxifylline to reduce release of inflammatory mediators and reactive oxidants after reperfusion. The scientifically most premising cardiac arrest interventions include: 1) continuous compressions versus standard CPR to improve survival, and 2) implementing therapeutic hypothermia immediately following restoration of circulation to reduce reperfusion injury and improve survival and qualitative outcome. The research design, rationale and techniques for achieving these proposals are specified in the application. Through this 6-year renewal, ROC will leverage its unparalleled infra-structure to significantly reduce morbidity and mortality from cardiac arrest and traumatic injury. Finally, the Toronto site also plans to expand training opportunities by applying for the Clinical Research Development Skills Core.

Public Health Relevance

Cardiovascular disease is the leading cause of death in the United States. Trauma is the leading cause of death among children, adolescents and young adults (ages 1-44) in North America. Improvements in survival and quality of life from continuing the Resuscitation Outcomes Consortium initiative will significantly impact these major national healthcare issues.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project--Cooperative Agreements (U01)
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Study Section
Special Emphasis Panel (ZHL1-CSR-I (01))
Program Officer
Sopko, George
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St. Michael's Hospital
Zip Code
M5 1-W8
Kudenchuk, Peter J; Brown, Siobhan P; Daya, Mohamud et al. (2014) Resuscitation Outcomes Consortium-Amiodarone, Lidocaine or Placebo Study (ROC-ALPS): Rationale and methodology behind an out-of-hospital cardiac arrest antiarrhythmic drug trial. Am Heart J 167:653-9.e4
Zelnick, Leila R; Morrison, Laurie J; Devlin, Sean M et al. (2014) Addressing the challenges of obtaining functional outcomes in traumatic brain injury research: missing data patterns, timing of follow-up, and three prognostic models. J Neurotrauma 31:1029-38
Wang, Henry E; Brown, Siobhan P; MacDonald, Russell D et al. (2014) Association of out-of-hospital advanced airway management with outcomes after traumatic brain injury and hemorrhagic shock in the ROC hypertonic saline trial. Emerg Med J 31:186-91
Rea, Thomas; Prince, David; Morrison, Laurie et al. (2014) Association between survival and early versus later rhythm analysis in out-of-hospital cardiac arrest: do agency-level factors influence outcomes? Ann Emerg Med 64:1-8
Callaway, Clifton W; Schmicker, Robert H; Brown, Siobhan P et al. (2014) Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest. Resuscitation 85:657-63
Minei, Joseph P; Fabian, Timothy C; Guffey, Danielle M et al. (2014) Increased trauma center volume is associated with improved survival after severe injury: results of a Resuscitation Outcomes Consortium study. Ann Surg 260:456-64; discussion 464-5
Nishiyama, Chika; Brown, Siobhan P; May, Susanne et al. (2014) Apples to apples or apples to oranges? International variation in reporting of process and outcome of care for out-of-hospital cardiac arrest. Resuscitation 85:1599-609
Cheskes, Sheldon; Schmicker, Robert H; Verbeek, P Richard et al. (2014) The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial. Resuscitation 85:336-42
Junger, Wolfgang G; Rhind, Shawn G; Rizoli, Sandro B et al. (2013) Prehospital hypertonic saline resuscitation attenuates the activation and promotes apoptosis of neutrophils in patients with severe traumatic brain injury. Shock 40:366-74
Brooks, Steven C; Hsu, Jonathan H; Tang, Sabrina K et al. (2013) Determining risk for out-of-hospital cardiac arrest by location type in a Canadian urban setting to guide future public access defibrillator placement. Ann Emerg Med 61:530-538.e2

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