BC RESURECT: 20 years of advancing resuscitation science

For over two decades, the BC Resuscitation Research Collaborative (BC RESURECT) has brought together clinicians, scientists, and first responders to develop research strategies to improve survival from cardiac arrest in Canada. A Clinical Academic Research Group affiliated with Providence Research and the University of British Columbia (UBC), BC RESURECT advances resuscitation science through clinical trials, observational studies, surveillance, quality improvement initiatives, and knowledge translation. 

Co-directed by Drs. Jim Christenson and Brian Grunau, BC RESURECT is a leader in its field, contributing to national and international treatment guidelines. The group is a key contributor to initiatives like the Canadian Resuscitation Outcomes Consortium (CanROC) and Canadians Saving Arrest Victims Everywhere (CanSAVE), which aim to transform cardiac arrest response systems and improve survival rates nationwide.

Cardiac arrest is a significant health concern

Cardiac arrest occurs when the heart suddenly stops beating. It can affect anyone, regardless of age, and is a leading cause of death - particularly when it occurs outside of a hospital setting.

“The number of cases per year is more than the number of deaths from COVID and the opioid crisis combined, even at the height of COVID deaths,” says Dr. Christenson. 

A 2024 report from the Heart & Stroke Foundation of Canada, which utilized data contributed by BC RESURECT, found that approximately 60,000 out-of-hospital cardiac arrests (OHCAs) occur annually in Canada - significantly more than previously estimated. Factors contributing to this increase include improved data collection, the opioid crisis, and the COVID-19 pandemic. In the United States, the annual number of OHCAs exceeds 356,000.

Currently, only about 5% of individuals who experience an OHCA survive. Early recognition, immediate CPR, and the use of automated external defibrillators (AEDs) are critical to improving outcomes. 

“Cardiac arrest can affect anyone at any time. While most medical interventions make relatively modest or long-term impacts on our lives, identifying methods to improve treatments for cardiac arrest can literally make the difference between life and death on a single day,” says Dr. Grunau.

Journey to becoming BC RESURECT

The BC Resuscitation Research Unit, which would later be renamed BC RESURECT, was established in 2005 with a focus on tracking and studying OHCA cases in urban B.C. It was one of ten North American groups in the Resuscitation Outcomes Consortium, and performed numerous clinical trials, studies, and quality improvement initiatives over the next decade, with multiple high-impact publications. 

In 2015, the unit formalized the B.C. Cardiac Arrest Registry, which collected data on all out-of-hospital cardiac arrests responded to by B.C. Emergency Health Services and Fire Department first responders in B.C.’s metropolitan regions. In 2019, this was expanded to include data from every out-of-hospital cardiac arrest in the province. 

“The registry is an important public health surveillance tool, and a quality assessment metric for our system overall,” says Dr. Grunau.

With support from a UBC Grant for Catalyzing Research Clusters, the unit created the national research group CanSAVE in 2020, which aims to achieve world-leading cardiac arrest survival rates by focusing on three key areas:

• Improving recognition of sudden cardiac arrest.
• Reducing response times for CPR and defibrillation before paramedics arrive.
• Enhancing brain protection and recovery post-resuscitation.

“It's an opportunity for us to share best practices to improve cardiac arrest in various communities across the country, and to understand more about those patients, and what we might be able to do to improve their survival,” says Dr. Christenson.

CanSAVE researchers explore a wide range of topics, including community response strategies, CPR and AED training, AI-assisted emergency dispatch, neurological outcomes, and post-hospital recovery.

“Understanding sudden cardiac arrest and its profound impact requires that we consider the entire patient journey. Each stage is inextricably linked, with outcomes in one stage impacting what happens next,”says Uda Walker, Research Manager for BC RESURECT and CanSAVE.

The BC Resuscitation Research Unit was formally renamed in 2021, becoming BC RESURECT. It continues to strengthen B.C.’s contributions to resuscitation science and improve survival from cardiac arrest on a local, national, and international level. 

Impactful research to improve cardiac arrest outcomes

BC RESURECT has a strong record of producing impactful research. Data collected through its registry supports a wide range of studies and clinical trials, exploring topics such as drug efficacy, treatment outcomes across different demographics, and the importance of bystander intervention.

One notable study currently in progress is the EpiDose trial, which is testing the effectiveness of a lower dose of epinephrine during OHCA resuscitations compared to the current standard. While epinephrine can help reverse cardiac arrest by increasing blood flow to the heart and other organs, research has suggested that a lower dose than may improve long-term outcomes.

Another groundbreaking project, led by Dr. Grunau, is the development of a wearable biosensor that is capable of detecting cardiac arrest as it happens and alerting emergency services. While commercially available smart watches can detect heart rates, detecting cardiac arrest requires a different formula. These devices, currently in the testing stage, could potentially transform outcomes for the 75% of cardiac arrests that are unwitnessed.

Research extends beyond cardiac arrest

BC RESURECT also conducts research on topics beyond cardiac arrest. The FRONTIER trial, led by Dr. Christenson and recently published in The Lancet, explored the ability of nerinetide to mitigate the damaging effects of stroke. Nerinetide slows the process of brain cell death, and the trial’s findings suggest that patients who received it in the field had improved neurological outcomes. 

In 2021, Dr. Grunau led a study, funded by the COVID-19 Immunity Task Force, that investigated paramedics’ risk of COVID-19 infection and the optimal interval for vaccinations. The study found that vaccinated paramedics were not at increased risk compared to the general population, while unvaccinated paramedics were more vulnerable. In a manuscript published in the Journal of the American Medical Association (JAMA), the study also reported that longer intervals between vaccine doses led to a stronger immune response. 

For twenty years, BC RESURECT has stood at the forefront of resuscitation science. Through data, innovation, and collaboration, they continue to push the envelope on how cardiac arrest and other conditions are understood and treated in B.C., Canada, and beyond.