Improving Outcomes in Cardiac Arrest With Inhaled Nitric Oxide
Overview
- Phase
- Early Phase 1
- Intervention
- inhaled nitric oxide
- Conditions
- Cardiac Arrest
- Sponsor
- Stony Brook University
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Rate of return of spontanueous circulation (ROSC)
- Last Updated
- 6 years ago
Overview
Brief Summary
Sudden cardiac arrest (CA) is a leading cause of death worldwide. CA claims the lives of an estimated 300,000 Americans each year. Despite advances in cardiopulmonary resuscitation (CPR) methods, only approximately 10% of adults with CA survive to hospital discharge, and up to 60% of survivors have moderate to severe cognitive deficits 3 months after resuscitation. Most of the immediate and post-CA mortality and morbidity are caused by global ischemic brain injury. The goal of this grant application is to test the hypothesis that resuscitation from cardiac arrest can be improved by improving cerebral oxygenation through inhalation of nitric oxide. This strategy will also improve the chances of return of spontaneous circulation (ROSC), improve short-term survival and neurologic outcome.
Investigators
Jignesh Patel
Associate Professor of Medicine
Stony Brook University
Eligibility Criteria
Inclusion Criteria
- •Age 18 years and above
- •In-hospital cardiac arrest as defined by cessation of heartbeat
- •Presence of Endotracheal Tube
Exclusion Criteria
- •Age below 18 years
- •Absence of Endotracheal Tube
- •Patients with out-of-hospital cardiac arrest
- •Patients involved in trauma and/or patients in the SICU or CTICU
- •Preexisting intra-cerebral lesions such as any head injury (old or new), brain hematoma, cerebral hemorrhage or known frontal lobe disorders such as tumors
- •Any patient with a terminal condition that cannot be treated (specifically any terminal malignancy, end stage lung fibrosis, chronic heart failure with an ejection fraction \<20%)
- •Patients with do not resuscitate and/or do not intubate (DNR/DNI) status
- •Therapeutic window has passed
Arms & Interventions
inhaled nitric oxide
Inhaled Nitric Oxide at 40 ppm will be administered in adults who suffer in hospital cardiac arrest. The administration of inhaled nitric oxide at 40 ppm will be provided upto 24 hours once ROSC is achieved.
Intervention: inhaled nitric oxide
Outcomes
Primary Outcomes
Rate of return of spontanueous circulation (ROSC)
Time Frame: 1 day
The primary outcome measure is to evaluate rates of return of spontaneous circulation (ROSC) from in hospital cardiac arrest patient who receive inhaled nitric oxide
Change in cerebral oxygenation (rSO2)
Time Frame: 1 day
The outcomes measure is to evaluate change in the concentration of cerebral oxygenation measured by Near-infrared spectroscopy before and after the administration of inhaled nitric oxide
Secondary Outcomes
- Neurologic outcomes at hospital discharge(upto 24 weeks)
- short term survival(upto 24 weeks)