# Improving Care after cardiac arrest by informing surrogate decision makers

> **NIH NIH K23** · UNIVERSITY OF COLORADO DENVER · 2020 · $53,559

## Abstract

PROJECT SUMMARY – Improving care after cardiac arrest by informing surrogate decision makers
Survival and neurological recovery after cardiac arrest are highly variable, driven in part by inconsistent
hospital care following successful resuscitation. Significant variability in delivery of evidence based, guideline
concordant care has been associated with differences in overall outcome from cardiac arrest. When guidelines
are followed, survival with good neurologic recovery is improved. However, adherence to guidelines regarding
delayed decision to withdraw life support has been highly variable across US hospitals. Reasons attributed to
early withdrawal of life sustaining therapy include poor knowledge of national and international guidelines,
requests from family for early outcome predications, and incomplete family comprehension of critical care. In
order to encourage utilization of guideline concordant delayed neuro-prognostication and concomitant
withdrawal of life-sustaining therapy (>72 hours after resuscitation) we propose a novel approach; to educate
and inform surrogate decision makers on neuro-prognostic uncertainty and guideline concordant care. The
research proposed in this career development award is intended to create a novel intervention that will
encourage improved guideline adherence on neuro-prognostication and delayed WLST as well as to support
the continued development of Dr. Sarah Perman, an early investigator committed to improving outcomes from
out-of-hospital cardiac arrest. Aim 1 will utilize qualitative methodology to interview key stakeholders in
decision making for comatose post-cardiac arrest patients (physicians, nurses, surrogate decision makers) to
identify knowledge gaps and determine barriers to guideline concordant post-cardiac arrest care. Aim 2 will
allow us to develop and refine educational tools to address neuro-prognostic uncertainty and guideline
concordant post-arrest care. Utilizing a panel of cardiac arrest experts and stakeholder focus groups we will
perform an iterative process to refine the tools and address potential barriers to implementation. Finally, in Aim
3 we will pilot test our educational tools in an equivalent time-samples quasi-experiment where we implement
the tools in the University of Colorado Hospital Emergency Department for surrogate decision makers of
resuscitated out of hospital cardiac arrest patients to explore feasibility and acceptability for widespread
implementation. The results of the pilot trial will further inform the design of a multi-center pragmatic clinical
trial to implement the educational tool in order to encourage guideline concordant post-cardiac arrest care
including delayed neuro-prognostication and delayed withdrawal of life-sustaining therapy. Overall, we
hypothesize that informing surrogate decision makers on guideline concordant care, will result in delayed
decisions to withdraw life-sustaining therapy and allow the post-arrest patient adequate timing for app...

## Key facts

- **NIH application ID:** 10176880
- **Project number:** 3K23HL138164-04S1
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Sarah M Perman
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $53,559
- **Award type:** 3
- **Project period:** 2017-08-18 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10176880

## Citation

> US National Institutes of Health, RePORTER application 10176880, Improving Care after cardiac arrest by informing surrogate decision makers (3K23HL138164-04S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10176880. Licensed CC0.

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