The study protocol for the LINC (LUCAS in cardiac arrest) study: a study comparing conventional adult out-of-hospital cardiopulmonary resuscitation with a concept with mechanical chest compressions and simultaneous defibrillation

Sten Rubertsson, Johan Silfverstolpe, Liselott Rehn, Thomas Nyman, Rob Lichtveld, Rene Boomars, Wendy Bruins, Björn Ahlstedt, Helena Puggioli, Erik Lindgren, David Smekal, Gunnar Skoog, Robert Kastberg, Anna Lindblad, David Halliwell, Martyn Box, Fredrik Arnwald, Bjarne Madsen Hardig, Douglas Chamberlain, Johan Herlitz, Rolf Karlsten, Sten Rubertsson, Johan Silfverstolpe, Liselott Rehn, Thomas Nyman, Rob Lichtveld, Rene Boomars, Wendy Bruins, Björn Ahlstedt, Helena Puggioli, Erik Lindgren, David Smekal, Gunnar Skoog, Robert Kastberg, Anna Lindblad, David Halliwell, Martyn Box, Fredrik Arnwald, Bjarne Madsen Hardig, Douglas Chamberlain, Johan Herlitz, Rolf Karlsten

Abstract

Background: The LUCAS™ device delivers mechanical chest compressions that have been shown in experimental studies to improve perfusion pressures to the brain and heart as well as augmenting cerebral blood flow and end tidal CO2, compared with results from standard manual cardiopulmonary resuscitation (CPR). Two randomised pilot studies in out-of-hospital cardiac arrest patients have not shown improved outcome when compared with manual CPR. There remains evidence from small case series that the device can be potentially beneficial compared with manual chest compressions in specific situations. This multicentre study is designed to evaluate the efficacy and safety of mechanical chest compressions with the LUCAS™ device whilst allowing defibrillation during on-going CPR, and comparing the results with those of conventional resuscitation.

Methods/design: This article describes the design and protocol of the LINC-study which is a randomised controlled multicentre study of 2500 out-of-hospital cardiac arrest patients. The study has been registered at ClinicalTrials.gov (https://ichgcp.net/clinical-trials-registry/NCT00609778?term=LINC&rank=1).

Results: Primary endpoint is four-hour survival after successful restoration of spontaneous circulation. The safety aspect is being evaluated by post mortem examinations in 300 patients that may reflect injuries from CPR.

Conclusion: This large multicentre study will contribute to the evaluation of mechanical chest compression in CPR and specifically to the efficacy and safety of the LUCAS™ device when used in association with defibrillation during on-going CPR.

Figures

Figure 1
Figure 1
The separate algorithm used for patients suffering a cardiac arrest witnessed by the ambulance crew and used for these witnessed cases for eligible judgment and randomisation into the LINC-study.
Figure 2
Figure 2
The LUCAS algorithm used in the LINC-study.
Figure 3
Figure 3
The adult ALS algorithm used as control in the LINC-study.

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Source: PubMed

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