Manual pressure augmentation in defibrillation of ventricular arrhythmias (AUGMENT RCT)

Associate Professor Dion Stub, Monash University

2022 Vanguard Grant

Years funded: 2023-2024

In patients suffering from out-of-hospital cardiac arrest, timely successful defibrillation is critical to survival.

We plan to assess a technique called manual pressure augmentation (MPA), whereby operators wearing latex gloves push down on the sternal and apical patches at the time of energy delivery ('hands on defibrillation') in the cardiac arrest setting. This has been shown to be more effective in non-cardiac arrest settings.

We perfomed a benchtop study and pilot trial indicating MPA to be safe and effective. We plan to run a world first randomised controlled trial of cardiac arrest patients that compares MPA with standard ('hands off') defibrillation. We hope to show that manual pressure augmentation is a superior approach associated with improved efficacy and survival to hospital discharge.

This study has the potential to change clinical practice for resuscitation of both in-hospital and out-of-hospital cardiac arrest worldwide and, if positive, would be incorporated into international Advanced Cardiac Life Support guidelines