CAvent-Ventilation During Advanced Cardiopulmonary Resuscitation in Out-of-hospital Cardiac Arrest- a Descriptive Study
Study Details
Study Description
Brief Summary
The aim with this descriptive multicenter study is to examine the quality of the ventilation given by Emergency Medical Service (EMS) personnel during cardiopulmonary resuscitation (CPR).
Primary endpoint is the ventilation quality measured as ventilation frequency, tidal volume and minute ventilation.
This will primarily be studied during CPR with a 30 compression/2 ventilation ratio performed by the EMS personnel where the airway is managed with a supraglottic device but also in CPR with continuous ventilation (8-10 breaths/minute) after the airway management have been replaced with an endotracheal within the emergency room.
The inclusion of patients will be performed at two sites (Uppsala; Sweden and Utrecht; Holland), all out-of-hospital cardia arrest (OHCA) patients will receive care according to current CPR guidelines using mechanical chest compressions.
| Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
The inclusion is estimated to run over a two-year period to reach the goal of at least 200 patients. The study has been preceded by a trial period in an effort to solve any logistic and technical problems.
The study will be a prospective descriptive multicenter study where measurement of ventilation data will be sampled during CPR by EMS treating patients with OHCA. Any results from standard laboratory tests related to ventilation quality will be retracted from the patient medical journal systems. In addition to ventilatory variables measured as endpoints, secondary endpoints will also be outcome measures as any ROSC, survival and neurological outcome (mRS, GOS-E) measured at 30 days and at 6 months.
Study Design
Outcome Measures
Primary Outcome Measures
- Ventilation frequency [From start of CPR to end of CPR.]
Measured as ventilations per minute.
- Tidal volume [From start of CPR to end of CPR.]
Measured as milliliters per ventilation.
- Minute Ventilation [From start of CPR to end of CPR.]
Measured as litres per minute.
Secondary Outcome Measures
- Variation of etCO2 in relation to different ratios of compression to ventilations [From start of CPR to end of CPR.]
etCO2 measured as kilopascal for each exhalation during CPR with 30 compressions and 2 ventilations and during continous compressions and ventilations.
- Time of inspiration [From start to end of CPR.]
Measured as seconds for each inspiration.
- Fraction of dead space ventilation [From start of CPR to end of CPR..]
Dead space measured as milliliters for each ventilation compared to the tidal volume in milliters for that same ventilation.
- Peak inspiratory pressure during ventilation [From start of CPR to end of CPR.]
Measured as cmH20 for each ventilation.
- Survival rate [30 days post cardiac arrest]
Number of patients that has survived after the cardiac arrest.
- Neurological outcome [30 days post cardiac arrest]
Measured with the modified Ranking Scale (mRS).
- Neurological outcome [30 days post cardiac arrest.]
Measured with the Glascow Outcome Scale -Extended (GOS-E).
- Survival rate [6 months post cardiac arrest]
Number of patients that has survived after the cardiac arrest..
- Neurological outcome [6 months post cardiac arrest]
Measured with the modified Ranking Scale (mRS).
- Neurological outcome [6 months post cardiac arrest.]
Measured with the Glascow Outcome Scale -Extended (GOS-E).
Eligibility Criteria
Criteria
Inclusion Criteria:
Out-of-hospital cardiac arrest (OHCA) treated with CPR performed by the EMS personnel
Exclusion Criteria:
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Patient age < 18 years
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Known pregnancy
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Trauma related cardiac arrest (inc. hanging)
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Regionale Ambulance Voorziening Utrecht, Netherlands | Amersfoort | Utrecht | Netherlands | |
| 2 | Uppsala University hospital | Uppsala | Sweden | 75185 |
Sponsors and Collaborators
- Uppsala University
- Regionale Ambulance Voorziening, Amersfoort, Utrecht, Netherlands
Investigators
- Principal Investigator: Sten Rubertsson, PhD, Uppsala University department of surgical sciences
- Study Chair: David Smekal, PhD, Uppsala University department of surgical sciences
- Study Chair: Johan Mällberg, BsSC, Uppsala University department of surgical sciences
- Study Chair: René Boomars, MSc, Regionale Ambulance Voorziening Utrecht (RAVU)
- Study Chair: Thijs Verhagen, MD, Regionale Ambulance Voorziening Utrecht (RAVU)
Study Documents (Full-Text)
None provided.More Information
Publications
- Axelsson C, Karlsson T, Axelsson AB, Herlitz J. Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) versus manual CPR according to pressure of end tidal carbon dioxide (P(ET)CO2) during CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation. 2009 Oct;80(10):1099-103. doi: 10.1016/j.resuscitation.2009.08.006. Epub 2009 Aug 28.
- Becker TK, Berning AW, Prabhu A, Callaway CW, Guyette FX, Martin-Gill C. An assessment of ventilation and perfusion markers in out-of-hospital cardiac arrest patients receiving mechanical CPR with endotracheal or supraglottic airways. Resuscitation. 2018 Jan;122:61-64. doi: 10.1016/j.resuscitation.2017.11.054. Epub 2017 Nov 23.
- Gräsner JT, Lefering R, Koster RW, Masterson S, Böttiger BW, Herlitz J, Wnent J, Tjelmeland IB, Ortiz FR, Maurer H, Baubin M, Mols P, Hadžibegovíc I, Ioannides M, Škulec R, Wissenberg M, Salo A, Hubert H, Nikolaou NI, Lóczi G, Svavarsdóttir H, Semeraro F, Wright PJ, Clarens C, Pijls R, Cebula G, Correia VG, Cimpoesu D, Raffay V, Trenkler S, Markota A, Strömsöe A, Burkart R, Perkins GD, Bossaert LL; EuReCa ONE Collaborators. Corrigendum to "EuReCa ONE-27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe" [Resuscitation 105 (2016) 188-195]. Resuscitation. 2016 Dec;109:145-146. doi: 10.1016/j.resuscitation.2016.10.001. Epub 2016 Oct 15.
- Hollenberg J, Svensson L, Rosenqvist M. Out-of-hospital cardiac arrest: 10 years of progress in research and treatment. J Intern Med. 2013 Jun;273(6):572-83. doi: 10.1111/joim.12064. Epub 2013 Apr 1. Review.
- Kern KB, Hilwig RW, Berg RA, Sanders AB, Ewy GA. Importance of continuous chest compressions during cardiopulmonary resuscitation: improved outcome during a simulated single lay-rescuer scenario. Circulation. 2002 Feb 5;105(5):645-9.
- Nizhenkovska IV, Pidchenko VT, Bychkova NG, Bisko NA, Rodnichenko AY, Kozyko NO. Influence of Ganoderma lucidum (Curt.: Fr.) P. Karst. on T-cell-mediated immunity in normal and immunosuppressed mice line CBA/Ca. Ceska Slov Farm. 2015 Sep;64(4):139-43.
- Nolan JP, Soar J, Zideman DA, Biarent D, Bossaert LL, Deakin C, Koster RW, Wyllie J, Böttiger B; ERC Guidelines Writing Group. European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation. 2010 Oct;81(10):1219-76. doi: 10.1016/j.resuscitation.2010.08.021.
- Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Gräsner JT, Wenzel V, Ristagno G, Soar J; Adult basic life support and automated external defibrillation section Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99. doi: 10.1016/j.resuscitation.2015.07.015. Epub 2015 Oct 15.
- Perkins GD, Olasveengen TM, Maconochie I, Soar J, Wyllie J, Greif R, Lockey A, Semeraro F, Van de Voorde P, Lott C, Monsieurs KG, Nolan JP; European Resuscitation Council. European Resuscitation Council Guidelines for Resuscitation: 2017 update. Resuscitation. 2018 Feb;123:43-50. doi: 10.1016/j.resuscitation.2017.12.007. Epub 2017 Dec 9.
- Pollack RA, Brown SP, Rea T, Aufderheide T, Barbic D, Buick JE, Christenson J, Idris AH, Jasti J, Kampp M, Kudenchuk P, May S, Muhr M, Nichol G, Ornato JP, Sopko G, Vaillancourt C, Morrison L, Weisfeldt M; ROC Investigators. Impact of Bystander Automated External Defibrillator Use on Survival and Functional Outcomes in Shockable Observed Public Cardiac Arrests. Circulation. 2018 May 15;137(20):2104-2113. doi: 10.1161/CIRCULATIONAHA.117.030700. Epub 2018 Feb 26.
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