Cardiopulmonary ArrestNCT05474170
Impact of 2 Resuscitation Sequences on Management of Simulated Pediatric Cardiac Arrest
A study testing AHA resuscitation sequence and ERC resuscitation sequence in people with Cardiopulmonary Arrest and Pediatric ALL, run by Geneve TEAM Ambulances at 1 site in Switzerland.
Trial summary
The International Liaison Committee on Resuscitation regularly publishes a Consensus on Science with Treatment Recommendations but guidelines can nevertheless differ when knowledge gaps persist. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Cardiopulmonary Arrest, Pediatric ALL, Resuscitation
- What is being tested?
- AHA resuscitation sequence and ERC resuscitation sequence
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 28 participants
- Where
- 1 siteSwitzerland
- Study dates
- 1 Sep 2022to 1 Sep 2022
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Being issued from one of the following profession: Emergency medical technicians (EMTs), paramedics, nurses and physicians
Who cannot join
- Being member of the study team
Trial locations and contacts
1 site in 1 country.
Switzerland1 site
Swiss Prehospital Research Day
Neuchâtel, Canton of Neuchâtel, 2000
About this study
Official title: Impact of 2 Resuscitation Sequences on Alveolar Ventilation During the First Minute of Simulated Pediatric Cardiac Arrest: Randomized Cross-Over Trial
The International Liaison Committee on Resuscitation regularly publishes a Consensus on Science with Treatment Recommendations but guidelines can nevertheless differ when knowledge gaps persist. In case of pediatric cardiac arrest, the American Heart Association recommends following the adult resuscitation sequence i.e., starting with chest compressions. Conversely, the European Resuscitation Council advocates the delivery of 5 initial rescue breaths before starting chest compressions. Carrying out a randomized trial in children in cardiac arrest to assess the impact of these strategies would prove particularly challenging and ethical concerns may prevent such a trial from being performed. This will be a superiority, cross-over randomized trial whose goal is to determine the impact of these 2 resuscitation sequences on alveolar ventilation in a pediatric model of cardiac arrest. While not definitive, its results could help fill part of the current knowledge gap.
Read the detailed description
This will be a randomized, cross-over, superiority trial. The intention is to carry it out on the first Prehospital Research Day which will be held on September 1st, 2022, i.e., on a single date. This event will take place at a single center in Neuchâtel, Switzerland. If the intended sample size cannot be reached on this day, or if technical issues prevent data from being collected or extracted, other study sites will be considered.
Participant recruitment will be conducted online. A web-based platform based on the Joomla 4 (Open Source Matters, New York, USA) content management system will be specifically created for the purpose of this study. The Event Booking 4 component (Joomdonation, Hanoi, Vietnam) will be used to create 20-minute time slots. Demographic data will be collected during the registration process. Consent will be gathered electronically.
Since the objective of this study is to assess the impact of basic airway management and ventilation maneuvers only, there will be no stratification since all the professionals eligible for inclusion should be equally proficient in basic airway management. Furthermore, all participants will be able to practice this skill on a manikin identical to the one used to perform the study. This training will not be time limited and will take place immediately before the sequence during which data will be collected.
An investigator who will not be present during the resuscitation sequences will create stacks of opaque, sealed envelopes. Each stack of 10 envelopes will contain an equal number of American Heart Association (AHA) and European Resuscitation Council (ERC) allocations. Randomization will take place after the training session. The first leader will choose and open one of the envelopes placed on a table in random order by one of the on-site investigators. This will determine the resuscitation sequence which will first be used by the team.
A SimBaby manikin (Laerdal SimBaby, Laerdal Medical, Stavanger, Norway) will be used in this study. The SimBaby is a realistic manikin representing a 9-month-old infant. The manikin weighs 4.9 kg and is 71 cm tall. It is accompanied with a dedicated multiparameter monitor/defibrillator. Back compensation, using a folded blanket, will be applied. An appropriately sized bag-valve-mask (BVM) device will be ready for use next to the manikin. The defibrillation pads will be already attached.
Participants will be told that they are facing a 9-month old infant who suddenly collapsed. They will be told that there is no foreign body airway obstruction and that the infant is in cardiac arrest.
Each team of two people will perform 4 resuscitation sequences of one minute each. Each participant will act as leader for two successive resuscitation sequences, the first of which will be carried out according to the random allocation described above. The scenario will be identical for all resuscitation sequences. After completing these two sequences, participants will exchange their roles, and the new leader will pick up another opaque, sealed envelope. The content of this envelope will determine the resuscitation sequence the newly appointed leader will have to use first.
The timer will start (T0) at the moment when the first action (chest compression or ventilation) will have been performed and will stop exactly after 60 seconds.
It will not be possible to blind the participants or the on-site investigators as to the design of the study or even to the allocation of the participants. Nevertheless, the outcomes will not be communicated to the participant. In addition, data extraction will be fully automated and the statistician will not know the identity of the participants or the sequence they were allocated to.
- Conditions
- Cardiopulmonary Arrest, Pediatric ALL, Resuscitation
- Being tested
- AHA resuscitation sequence, ERC resuscitation sequence
- Medical subject headings
- Heart Arrest, Precursor Cell Lymphoblastic Leukemia-Lymphoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AHA resuscitation sequenceOther
Starting the cardiopulmonary resuscitation by following the AHA guideline, meaning starting with 15 chest compressions, followed by 2 ventilations
ERC resuscitation sequenceOther
Starting the cardiopulmonary resuscitation by following the ERC guideline, meaning starting with 5 initial ventilations, then alternating 15 chest compressions with 2 ventilations
| Study group | Role | What they receive |
|---|---|---|
| AHA --> ERC | Experimental | This group will first apply the AHA resuscitation sequence, then the ERC one Receives: Other: AHA resuscitation sequence; Other: ERC resuscitation sequence |
| ERC --> AHA | Active comparator | This group will first apply the ERC resuscitation sequence, then the AHA one Receives: Other: AHA resuscitation sequence; Other: ERC resuscitation sequence |
What is being measured
The primary outcome is the main question the study is designed to answer.
Median Alveolar Ventilation
The alveolar ventilation was determined by subtracting the dead space volume from each ventilation. According to the appropriate Best Guess formula, a 9-month old infant should weigh around 9 kg (0.5 x age in months + 4.5). Using the formula proposed by Numa and Newth, this corresponds to a dead space of around 25 ml. The value reported was the median [quartiles] over the first minute.
Measured: 1 minute
Secondary outcomes (7)
The Total Number of Ventilations
This will be the count of the number of ventilations delivered during the one-minute scenario
Measured: 1 minute
The Percentage of Ventilations Within, Above and Below the Target Volume
According to the manikin's manufacturer, the target is 30 to 70 ml. >70 ml was considered "Above" and <30 ml was considered below.
Measured: 1 minute
The Alveolar Ventilation Obtained Without Taking Ventilation Volumes Over 70 ml Into Account, Reported as the Median Value of the Ventilations Over the First Minute.
This is similar to the primary outcome, but for this analysis, all ventilations were individually capped at 70 ml. The value reported was the median [quartiles] over the first minute.
Measured: 1 minute
The Percentage of Compressions of Correct Depth
The chest compression were considered correct if ≥ 4.3 cm, corresponding to one third of the height of the manikin's chest i.e., 13 cm). A second target of 3 cm or more was also reported.
Measured: 1 minute
The Percentage of Chest Compressions Within, Above and Below the Target Rate.
According to the guidelines, the target is 100 to 120 compressions per minute
Measured: 1 minute
The Chest Compression Fraction (CCF)
This corresponds to the time with compressions on the total time of the cardiopulmonary resuscitation sequence
Measured: 1 minute
The Percentage of Compressions With Adequate Chest Recoil
This corresponds to the proportion of compressions enough relaxed to let complete heart relaxation
Measured: 1 minute
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Jul 2022
- Study start1 Sep 2022
- Primary completion1 Sep 2022
- Study completion1 Sep 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Cardiopulmonary ArrestStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 28 participants (actual)
Sponsor and investigators
- Lead sponsor
- Geneve TEAM Ambulances
- Sponsor type
- University, hospital or other
- Collaborators
- Service de la protection et de la sécurité, Neuchâtel, École Supérieure de Soins Ambulanciers - College of Higher Education in Prehospital Care, University Hospital, Geneva
- Responsible party
- Principal investigator, Stuby Loric, Geneve TEAM Ambulances
- Investigators
- Laurent Suppan, MD, Principal investigator, University of Geneva Hospitals and Faculty of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05474170
- Sponsor's protocol ID
- CPR-AHA/ERC
- Status last verified
- Mar 2026
- First submitted
- 18 Jul 2022
- Last updated
- 3 Apr 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Anonymized data set will be made publicly available on the Digital Commons Data repository
Publications
Suppan L, Jampen L, Siebert JN, Zund S, Stuby L, Ozainne F. Impact of Two Resuscitation Sequences on Alveolar Ventilation during the First Minute of Simulated Pediatric Cardiac Arrest: Randomized Cross-Over Trial. Healthcare (Basel). 2022 Dec 5;10(12):2451. doi: 10.3390/healthcare10122451.
PubMed 36553975
Study at a glance
From the registry record, last updated by the sponsor on 3 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of 2 Resuscitation Sequences on Alveolar Ventilation During the First Minute of Simulated Pediatric Cardiac Arrest: Randomized Cross-Over Trial
- ClinicalTrials.gov ID
- NCT05474170
- Acronym / sponsor ID
- CPR-AHA/ERC
- Conditions
- Cardiopulmonary Arrest, Pediatric ALL, Resuscitation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 28 participants (actual)
- Lead sponsor
- Geneve TEAM AmbulancesUniversity, hospital or other
- Collaborators
- Service de la protection et de la sécurité, Neuchâtel, École Supérieure de Soins Ambulanciers - College of Higher Education in Prehospital Care, University Hospital, Geneva
- Study start
- 1 Sep 2022 (actual)
- Primary completion
- 1 Sep 2022 (actual)
- Study completion
- 1 Sep 2022 (actual)
- First posted
- 26 Jul 2022 (actual)
- Results
- Posted 3 Apr 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The International Liaison Committee on Resuscitation regularly publishes a Consensus on Science with Treatment Recommendations but guidelines can nevertheless differ when knowledge gaps persist. In case of pediatric cardiac arrest, the American Heart Association recommends following the adult resuscitation sequence i.e., starting with chest compressions. Conversely, the European Resuscitation Council advocates the delivery of 5 initial rescue breaths before starting chest compressions. Carrying out a randomized trial in children in cardiac arrest to assess the impact of these strategies would prove particularly challenging and ethical concerns may prevent such a trial from being performed. This will be a superiority, cross-over randomized trial whose goal is to determine the impact of these 2 resuscitation sequences on alveolar ventilation in a pediatric model of cardiac arrest. While not definitive, its results could help fill part of the current knowledge gap.
Detailed description
This will be a randomized, cross-over, superiority trial. The intention is to carry it out on the first Prehospital Research Day which will be held on September 1st, 2022, i.e., on a single date. This event will take place at a single center in Neuchâtel, Switzerland. If the intended sample size cannot be reached on this day, or if technical issues prevent data from being collected or extracted, other study sites will be considered.
Participant recruitment will be conducted online. A web-based platform based on the Joomla 4 (Open Source Matters, New York, USA) content management system will be specifically created for the purpose of this study. The Event Booking 4 component (Joomdonation, Hanoi, Vietnam) will be used to create 20-minute time slots. Demographic data will be collected during the registration process. Consent will be gathered electronically.
Since the objective of this study is to assess the impact of basic airway management and ventilation maneuvers only, there will be no stratification since all the professionals eligible for inclusion should be equally proficient in basic airway management. Furthermore, all participants will be able to practice this skill on a manikin identical to the one used to perform the study. This training will not be time limited and will take place immediately before the sequence during which data will be collected.
An investigator who will not be present during the resuscitation sequences will create stacks of opaque, sealed envelopes. Each stack of 10 envelopes will contain an equal number of American Heart Association (AHA) and European Resuscitation Council (ERC) allocations. Randomization will take place after the training session. The first leader will choose and open one of the envelopes placed on a table in random order by one of the on-site investigators. This will determine the resuscitation sequence which will first be used by the team.
A SimBaby manikin (Laerdal SimBaby, Laerdal Medical, Stavanger, Norway) will be used in this study. The SimBaby is a realistic manikin representing a 9-month-old infant. The manikin weighs 4.9 kg and is 71 cm tall. It is accompanied with a dedicated multiparameter monitor/defibrillator. Back compensation, using a folded blanket, will be applied. An appropriately sized bag-valve-mask (BVM) device will be ready for use next to the manikin. The defibrillation pads will be already attached.
Participants will be told that they are facing a 9-month old infant who suddenly collapsed. They will be told that there is no foreign body airway obstruction and that the infant is in cardiac arrest.
Each team of two people will perform 4 resuscitation sequences of one minute each. Each participant will act as leader for two successive resuscitation sequences, the first of which will be carried out according to the random allocation described above. The scenario will be identical for all resuscitation sequences. After completing these two sequences, participants will exchange their roles, and the new leader will pick up another opaque, sealed envelope. The content of this envelope will determine the resuscitation sequence the newly appointed leader will have to use first.
The timer will start (T0) at the moment when the first action (chest compression or ventilation) will have been performed and will stop exactly after 60 seconds.
It will not be possible to blind the participants or the on-site investigators as to the design of the study or even to the allocation of the participants. Nevertheless, the outcomes will not be communicated to the participant. In addition, data extraction will be fully automated and the statistician will not know the identity of the participants or the sequence they were allocated to.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| AHA --> ERC | Experimental | Other: AHA resuscitation sequence, Other: ERC resuscitation sequenceThis group will first apply the AHA resuscitation sequence, then the ERC one |
| ERC --> AHA | Active comparator | Other: AHA resuscitation sequence, Other: ERC resuscitation sequenceThis group will first apply the ERC resuscitation sequence, then the AHA one |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Being issued from one of the following profession: Emergency medical technicians (EMTs), paramedics, nurses and physicians
Key exclusion criteria (1 listed)
- Being member of the study team
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AHA resuscitation sequenceStarting the cardiopulmonary resuscitation by following the AHA guideline, meaning starting with 15 chest compressions, followed by 2 ventilations | Other | AHA --> ERC, ERC --> AHA |
| ERC resuscitation sequenceStarting the cardiopulmonary resuscitation by following the ERC guideline, meaning starting with 5 initial ventilations, then alternating 15 chest compressions with 2 ventilations | Other | AHA --> ERC, ERC --> AHA |
Primary outcome
Median Alveolar Ventilation
Time frame: 1 minute
The alveolar ventilation was determined by subtracting the dead space volume from each ventilation. According to the appropriate Best Guess formula, a 9-month old infant should weigh around 9 kg (0.5 x age in months + 4.5). Using the formula proposed by Numa and Newth, this corresponds to a dead space of around 25 ml. The value reported was the median [quartiles] over the first minute.
7 secondary outcomes
The Total Number of Ventilations
Time frame: 1 minute
The Percentage of Ventilations Within, Above and Below the Target Volume
Time frame: 1 minute
The Alveolar Ventilation Obtained Without Taking Ventilation Volumes Over 70 ml Into Account, Reported as the Median Value of the Ventilations Over the First Minute.
Time frame: 1 minute
The Percentage of Compressions of Correct Depth
Time frame: 1 minute
The Percentage of Chest Compressions Within, Above and Below the Target Rate.
Time frame: 1 minute
The Chest Compression Fraction (CCF)
Time frame: 1 minute
The Percentage of Compressions With Adequate Chest Recoil
Time frame: 1 minute
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Apr 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 36553975Suppan L, Jampen L, Siebert JN, Zund S, Stuby L, Ozainne F. Impact of Two Resuscitation Sequences on Alveolar Ventilation during the First Minute of Simulated Pediatric Cardiac Arrest: Randomized Cross-Over Trial. Healthcare (Basel). 2022 Dec 5;10(12):2451. doi: 10.3390/healthcare10122451.
- Whole project websiteLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. Anonymized data set will be made publicly available on the Digital Commons Data repository
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Laurent Suppan, MD principal investigator
University of Geneva Hospitals and Faculty of Medicine
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing AHA resuscitation sequence and ERC resuscitation sequence in people with Cardiopulmonary Arrest and Pediatric ALL, run by Geneve TEAM Ambulances at 1 site in Switzerland.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 3 Apr 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Median Alveolar Ventilation (time frame: 1 minute). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05474170, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Apr 2026.