Background

The OSCAR Network is a research group consisting of cardiac arrest reseachers from the previous Oslo Cardiopulmonary Research Group (from both Division of Emergencies and Critical Care and Prehospital Division), from the Intervention Centre at Rikshospitalet, and Cardiac ICU at Ullevål. OSCAR aim to challenge current guidelines on cardiac arrest management, through goaldirected pre- and inhospital research to improve weak links in the Chain of Survival. We are involved in methodological and pedacogical studies in manikin models, have established two advanced animal-experimental cardiac arrest models, do register-based epidemiological studies and different clinical trials, both observational and randomised. Focus in the clinical trials are related to both prehospital studies during cardiopulmonary resuscitation/advanced life support and inhospital studies to optimize post resuscitation care. Translation between lab and clinic is central; to better describe and understand the pathophysiology or test out new ideas. We have a broad international network and collaboration.

1. At the Intervention Centre (IVC) at OUH Rikshospitalet: pigs in cardiac arrest induced by coronary artery occlusion (ischemic heart model) resuscitated with extracorporeal membrane oxygenation (ECMO), exploring post ROSC heart function with and without esmolol
2. At the Institute of Experimental Medical Research (IEMR) at OUH Ullevål: pigs in cardiac arrest, electrically induced (arrhytmic model) resuscitated with the traditional Heart Lung Machine (HLM), exploring cerebral perfusion and metabolism with two different mean arterial pressures/post ROSC treatment strategies; MAP 60 mmHg vs. a MAP of 90 mmHg and normocapnia vs permissive hypercapnia both studies during both normotherma and hypothermia in both a normothermic (36-37 ^oC) and hypothermic (33^oC). In this model, we focus on post ROSC brain function, measuring cerebral blood flow, microdialysis (cerebral energy consumption and metabolism) and CO2 detection (ischemia-detection).
3. The inhospital NORCAST (NORwegian CArdiac arrest trial) exploring prognostication factors among hospitalized comatose cardiac arrest patients at OUH Ullevål. The NORCAST trial is completed (n=268 patients) and we are in the final analyzing period. Several substudies related to coronary interventions, haemodynamic management, acute kidney injury and cognitive assessment in survivors have been planned, some already being published.
4. A haemodynamic study in the physician staffed ambulance in Oslo, analyzing haemodynamic effects with advanced monitoring tools (invasive arterial blood pressure, end-tidal CO2, cerebral oxygen saturation with near-infrared spectroscopy (NIRS)) during mechanical CPR with or without active decompression during out-of-hospital cardiac arrest (OHCA).
5. Newborn resuscitation project – investigating and exploring newborn resuscitation and how to further improve treatment.
6. Some other cardiac arrest related projects in collaboration with the research group from Prehospital Division.

Professor Kjetil Sunde, Dept of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital
Mob 95224201   E.mail kjetil.sunde@medisin.uio.no