This application describes the unique resources Pittsburgh can provide as a Regional Clinical Center (RCC) in a Clinical Research Consortium to Improve Resuscitation Outcomes. Pittsburgh has assembled a multidisciplinary team dedicated to improving restoration of cardiovascular stability and minimizing brain injury. Unique resources include a strong working relationship with regional emergency medical services, one of the busiest trauma centers in the region, an integrated health care system, and a core of researchers focused on resuscitation. We have included plans to standardize care, assure protocol compliance, and perform detailed functional outcome assessment. We have mechanisms to control interventions for subjects in the field, in the emergency department, in the intensive care unit, in rehabiliation and at the time of functional evaluation. The baseline characteristics of cardiopulmonary arrest and traumatized patients are suitable for clinical research. We currently monitor the resuscitation and outcomes after cardiopulmonary arrest for over 500 individuals each year. We currently treat over 3600 trauma patients per year. Over 500 trauma patients per year have injury severity scores of 15 or greater, and about 150 trauma patients per year have fatal traumatic injuries using current therapy. Two concept trials are presented for the Consortium. The first will study (1) an increase in the number of chest compressions delivered per unit time and (2) different durations of induced hypothermia on survival and recovery after cardiopulmonary arrest. The second will examine the effect of intentional induction of mild hypothermia after trauma with hemorrhagic shock. A clinical research training core is also described for purposes of training a young investigator within the Consortium.
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