Which Patients With a ROSC After OHCA Would Potentially Benefit From Physician Driven Post Cardiac Arrest Care?
试验速览
- 阶段
- 不适用
- 入组人数
- 175
- 主要终点
- percentage of OHCA patients with a prehospital ROSC who arrive in hospital with either a deranged physiology or with complications from OHCA EMS personnel was unable to deal with
研究概览
简要总结
Rational: Out of hospital cardiac arrest is a devastating event with a high mortality. Survival rates have increased over the last years, with the availability of AED's and public BLS. Previous studies have shown that deranged physiology after return of spontaneous circulation (ROSC) is associated with a worse neurological outcome. Good quality post-arrest care is therefore of utmost importance.
Objective: To determine how often prehospital crews (with their given skills set) encounter problems meeting optimal post-ROSC targets in patients suffering from OHCA, and to investigate if this can be predicted based on patient-, provider- or treatment factors.
Study design: Prospective cohort study of all patients attended by the EMS services with an OHCA who regain ROSC and are transported to a single university hospital, in order to identify those patients with a ROSC after a non-traumatic OHCA who had deranged physiology and/or complications from OHCA EMS personnel was unable to prevent/deal with in the prehospital environment.
Study population: Patients, >18 years, transported by the EMS services to the ED of the University Hospital Groningen (UMCG) with a ROSC after OHCA in a 1 year period
Main study parameters/endpoints: Primary endpoint of our study is the percentage of OHCA patients with a prehospital ROSC who arrive in hospital with either a deranged physiology or with complications from OHCA EMS personnel was unable to deal with.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
结局指标
主要结局
percentage of OHCA patients with a prehospital ROSC who arrive in hospital with either a deranged physiology or with complications from OHCA EMS personnel was unable to deal with
时间窗: From pre-hospital ROSC to arrival at ED, approximately 1-2 hours
Any of the below 5 minutes or more after ROSC is obtained: * -Airway intervention (SGA or ETT) not performed (when deemed necessary) * Actively Vomiting in absence of ETT after ROSC B: -Hypoxia: -SaO2 \<94% on at least two consecutive readings * Hypercarbia: -ETCO2\>5.5 kPa on at least two consecutive readings\*\* C: -Low cardiac output: -Re-arrest during transport to hospital * ETCO2\<3.0 on two consecutive readings * MAP\<65mmHg on two consecutive readings * SBP\<100 mmHg on two consecutive readings upon arrival in ED D: -Hypoxic agitation upon arrival in ED or uncontrolled prehospital hypoxic agitation despite benzodiazepine administration or when benzodiazepines contraindicated) * Seizures during transport E: -Hyperthermia
次要结局
- Patient- and resuscitation factors related to deranged physiology and/or complications in the post arrest phase(From pre-hospital ROSC to arrival at ED, approximately 1-2 hours)
- Frequency distribution of hypoxic agitation upon arrival in ED or uncontrolled prehospital hypoxic agitation despite benzodiazepine administration or when benzodiazepines contraindicated)(From pre-hospital ROSC to arrival at ED, approximately 1-2 hours)
- Frequency distribution of the presence of hyperthermia(From pre-hospital ROSC to arrival at ED, approximately 1-2 hours)
- Frequency distribution of the presence of hypoxia(From pre-hospital ROSC to arrival at ED, approximately 1 to 2 hours)
- Frequency distribution of low cardiac output(From pre-hospital ROSC to ICU (or CCU) admission, up to about 1 hours)
- Opinion of EMS providers weather or not they felt they were able to provide optimal post arrest care(From pre-hospital ROSC to arrival at emergency department, approximately 1-2 hours)
- Comparison of primary outcome of secondary outcomes between post ROSC patients attended by EMS only vs EMS and HEMS(From pre-hospital ROSC to arrival at emergency department, approximately 1-2 hours)
- Frequency distribution of airway interventions (SGA or ETT) not performed (when deemed necessary)(From pre-hospital ROSC to arrival at emergency department, approximately 1-2 hours)
- Frequency distribution of actively vomiting in absence of ETT after ROSC in prehospital setting(From pre-hospital ROSC to arrival at ED, approximately 1 to 2 hours)
- Frequency distribution of seizures during transport(From pre-hospital ROSC to arrival at ED, approximately 1-2 hours)
- Duration of period with deranged physiology, measured from moment of first occurrence until resolved or until arrival in hospital.(From pre-hospital ROSC to arrival at ED, approximately 1-2 hours)
研究者
Fabian Lucassen
Principal Investigator
University Medical Center Groningen