Evaluation of Acid-base Disorders and Ventilation Settings in Cardiogenic Shock and Post-cardiac Arrest Patients: Comparison With VentilO Algorithm
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- Acid-base disorder (respiratory acidosis)
研究概览
简要总结
This study aims to better understand how mechanical ventilation settings affect patients admitted to the coronary care unit after cardiac arrest or with cardiogenic shock. These patients often require mechanical ventilation, but current guidelines provide limited evidence on the best approach. Improper ventilation settings can lead to acid-base imbalances, such as respiratory acidosis or alkalosis, which may worsen patient outcomes.
The retrospective analysis will include 100 adult patients (50 post-cardiac arrest and 50 with cardiogenic shock) who were mechanically ventilated upon admission. The study has two main objectives:
Determine how often acid-base disorders occur in these patients and describe their characteristics.
Compare the initial ventilator settings chosen by clinicians with those suggested by VentilO, a decision-support algorithm.
The investigators will evaluate the potential effect of the VentilO recommendations on the first arterial (or capillary) blood gases compared to the real settings.
This information will help refine the algorithm and guide future research on improving ventilation strategies for critically ill cardiac patients.
Participation does not involve any intervention, as the study uses existing medical records.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult (Age >=18 years old)
- •Under mechanical ventilation with endotracheal tube for :
- •post cardiac arrest or cardiogenic shock
- •- Bood gases result availability up to 4 hours after coronary unit admission
排除标准
- •Lack of patient anthropometric data (height and weight) available in the patient record
- •No information in the record regarding the data on the humidification systems used at the time of the first blood gas test upon admission to the coronary care unit.
- •Patient stabilzed in other hospital before coronary unit admission or adjustment of respiratory parameters after a blood gas test.
结局指标
主要结局
Acid-base disorder (respiratory acidosis)
时间窗: Up to 4 hours after admission to the coronary care unit - First blood gas sample
Presence of respiratory acisosis define by pH\< 7.35 and PaCO2 \> 45 mmHg
Acid-base disorder (respiratory alcalosis)
时间窗: Up to 4 hours after admission to the coronary care unit - First blood gas sample
Presence of respiratory alcalosis define by by pH\>7.45 and PaCO2 \< 35 mmHg
次要结局
- Ventilator setting (Respiratory rate)(Up to 4 hour after coronary unit admission - At the last ventilator setting before blood gas sample)
- Ventilator setting (Tidal volume)(Up to 4 hour after coronary unit admission - At the last ventilator setting before blood gas sample)
- Acid-base disorder (metabolic acidosis)(Up to 4 hours after admission to the coronary care unit - First blood gas sample)
- Acid-base disorder (metabolic alcalosis)(Up to 4 hours after admission to the coronary care unit - First blood gas sample)
- Optimal acid-base result(Up to 4 hours after admission to the coronary care unit - First blood gas sample)
- Mechanical ventilation duration(Up to 90 days)
- Vasopressor duration(Day 28)
- Hospital length of stay(Up to 90 days)
- Mortality(Day 28)
- Acute renal failure(Up to 90 days. Coronary unit stay - admission through discharge or until death if occured)
研究者
François Lellouche
Principal Investigator
Laval University