Acquired brain injuries (ABI), which occur after birth, are often due an out-of-hospital cardiac arrest (OHCA) where blood and oxygen supply to the brain are reduced leading to injury. In 2020, the emergency services in Ireland treated 2,906 OHCAs, and only 6.1% of these individuals were discharged alive (HSE Out-of-hospital Cardiac arrest register report 2021). Of those who are successfully resuscitated, 80% will have an ABI. Reducing death and disability, the economic costs and long-term societal effects are key drivers for this application.
The Irish Critical Care-Clinical Trials Network’s (ICC-CTN) ABI Research Programme, led by Prof Alistair Nichol, began over ten years ago investigating treatments for those who have suffered an OHCA. Since then, the ICC-CTN have delivered some of the largest randomised OHCA (and other relevant ABI) trials ever conducted with 2 further ongoing, to determine effective treatments safely using the highest trial design standards and delivering definitive evidence. Some of these trials (TAME, TTM2) have collected many biological samples from OHCA patients (>900). Initial analyses of these samples indicate that we may be able to identify which patients will have the poorest outcomes (prognostic factors), while identifying new treatments for enhanced patient care.
Through our PRECISION-ABI project, we aim to facilitate the harmonised collection of biological samples across our STEPCARE trial (OHCA), and conduct in-depth sample analyses for prognostic and disease factors. We will also investigate, for the first time, whether patient sub-groups exist in OHCA (e.g Hyper- and Hypo-inflammatory) and whether these different patient sub-groups may respond better, worse or not at all to specific treatments. We will incorporate the public and patient voice throughout while engaging with clinicians/researchers to determine the optimal research approach for OHCA. This will achieve our overall aim of advancing precision medicine approaches for OHCA patients and improving clinical outcomes.