# Improving Care After Cardiac Arrest by Informing Surrogate Decision Makers - Extension

> **NIH NIH K23** · UNIVERSITY OF COLORADO DENVER · 2021 · $67,408

## 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 COVID extension will pilot test 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. In this extension, we will continue a pilot trial of the Tool to
EMPOwer (TEMPO) Surrogate Decision Makers of comatose survivors of cardiac arrest at the University of
Colorado Hospital. This pilot is intended to determine feasibility and acceptability of the tool as well as
knowledge transferred regarding post-cardiac arrest care. We intend to utilize the pilot trial to prepare for
widespread implementation of TEMPO. 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 appropriate neuro-prognostication and awakening, thus improving outcomes from out-of-hospital cardiac
arrest. This will be the subject of a future independent research proposal by the applicant.

## Key facts

- **NIH application ID:** 10406548
- **Project number:** 3K23HL138164-04S2
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Sarah M Perman
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $67,408
- **Award type:** 3
- **Project period:** 2017-08-18 → 2022-03-09

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10406548

## Citation

> US National Institutes of Health, RePORTER application 10406548, Improving Care After Cardiac Arrest by Informing Surrogate Decision Makers - Extension (3K23HL138164-04S2). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10406548. Licensed CC0.

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