systems of care
Outcomes after cardiac arrest are strongly influenced by the system of care.
Our group has contributed to the development of American Heart Association guidelines for post-arrest care. We have completed observational research showing systems of post-arrest care are associated with long-term survival. Our Post-Cardiac Arrest Service cares for more than 400 patients annually, many of whom are transfered to our care from other hospitals around the region. Working in close partnership with STAT MedEvac, one of the largest academic critical care transport networks in the country, we are able to implement regionalization in practice by coordinating timely interfacility transfers and ensuring patients have access to advanced expertise regardless of where their arrest occurs.
To rigorously evaluate the value of regionalized specialty care, we are now conducting the SPARC Trial, a large NIH-funded randomized trial. This trial tests whether immediate transfer to a single specialty center improves outcomes compared with usual care at the presenting hospital, carefully considering both the benefits and risks of early interfacility transport. By quantifying the effects of specialty care on recovery, cost, and implementation, this study will provide the most definitive evidence to date about how systems of care should be structured to maximize survival and recovery for patients after cardiac arrest.
Recent Work
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In a broad scientific statement, we contributed to consensus guidance on ICU management after cardiac arrest spanning ventilation, hemodynamics, neuroprotection, and prognostication, with practical algorithms for bedside teams .
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We contributed to a scientific statement providing evidence informed recommendations for interfacility transport after cardiac arrest—covering ventilator strategies, sedation, monitoring, communication, and equity considerations across systems of care.