Researchers at 60 different intensive care units around the world are seeking to establish methods to expedite and improve post-cardiac arrest recovery at ICUs. The research is led by Markus Skrifvars, Staff Specialist in Anaesthesiology and Intensive Care and Professor of Prehospital Emergency Medicine at University of Helsinki, jointly with Professor Niklas Nielsen from Lund University. Professor Skrifvars’ part of the research is funded by the Research Council of Finland.

Every year, approximately 350,000 people in Europe and 1,500–2,000 people in Finland suffer from acute cardiac arrest. With rapid cardiopulmonary resuscitation, blood circulation can be restarted in roughly 30 per cent of the cases, with the patients then receiving further treatment at a university hospital or central hospital ICU. In Finland, for example, the number of patients treated annually is approximately 600–700.

Even with the circulation restored, there is a risk of hypoxic brain injury resulting from a lack of oxygen. “No specific treatments exist, although there have been attempts to establish one. It’s not been possible to verify factors that clearly reduce the development of brain injury,” says Skrifvars.

Professor Skrifvars’ part of the research entails trials to raise the patients’ blood pressure through medication. The aim is to maintain better blood supply to the brain and reduce the risk of brain injury.

The research also uses a large group of patients to investigate other interventions to further improve patients’ capacity for recovery. The researchers have ended up comparing alternative methods and goals for three different interventions. They are related to controlling the depth of sedation, body temperature and mean arterial pressure. The STEPCARE trial aims to identify the levels to achieve the best chance of recovery for patients.

“There are 3,500 patients across the world taking part in the research. We’re able to assemble a sufficient number of patients within a sensible time frame. With several different hospitals and patient groups involved, we can ensure definitive results with effective measures,” says Skrifvars.

Essential is the efficacy of the intervention, how the patient recovers and, first and foremost, whether the patient is still alive six months from the cardiac arrest. In cases where the heart stops and the person ends up in an intensive care unit, half of patients achieve good recovery and half die.

The extensive research project runs for 7–8 years. The research involves approximately twenty specialists from Finland and approximately 150 specialists globally. The entire care pathway is taken into account, involving both intensive care specialists, cardiologists, occupational therapists and physiotherapists.

“Once we have the results of our research, they may support existing recommendations or suggest entirely different policies. Our hope is that the care instructions based on the research published in 2027 will be adopted immediately the following year.”

As the research uses treatments that are currently in place, the risks are low and correspond to the standard risks related to treatment. The measures can be implemented anywhere in the world.

The countries involved in the research are Finland, Estonia, Sweden, Norway, Belgium, Luxembourg, the UK, Germany, Switzerland, Saudi Arabia, Singapore, Australia and New Zealand. The research is being launched in Ireland, the Netherlands, Austria, Italy, the Czech Republic and Kuwait.