REsuscitation and CAPillary rePerfusion - A Cohort Study With Prospective Inclusion
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cardiac Arrest
- Sponsor
- Medical University of Vienna
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Capillary refill time (CRT)
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
Persistent microperfusion alterations after return of spontaneous circulation (ROSC) are associated with poor survival. To our knowledge, no human studies evaluating microperfusion during cardiopulmonary resuscitation (CPR) with simple and pre-hospital available tests have been published. Capillary refill time (CRT) and skin-mottling-score (SMS) are parameters for microperfusion and evaluated in septic and cardiogenic shock. In animal studies, microperfusion was impaired during cardiac arrest, although not correlating with systemic blood pressure.
The aim of this study is to investigate the correlation between impaired microcirculation (as measured with CRT and SMS) during resuscitation and ROSC resp. neurological outcome. Our clinical impression in daily routine is, that the appearance of a patient undergoing CPR is often linked to the outcome. We hypothesize, that this is due to changes in microperfusion of the skin.
Investigators
Michael Holzer
Prof. Michael Holzer
Medical University of Vienna
Eligibility Criteria
Inclusion Criteria
- •All patients ≥18 years during cardiopulmonary resuscitation
- •witnessed cardiac arrest
Exclusion Criteria
- •insufficient manpower (e.g. study team has to provide CPR)
- •hypovolemia (exsanguination, anaphylaxis, sepsis as underlying cause)
- •presumed or known COVID-19 disease
- •hypo-/hyperthermia (\<36.0°, \>37.5°C)
- •Raynaud's disease
- •Peripheral arterial disease
Outcomes
Primary Outcomes
Capillary refill time (CRT)
Time Frame: baseline (immediately after inclusion to the study)
Capillary refill time in seconds measured on one finger and one earlobe for ROSC vs. no ROSC
Secondary Outcomes
- Skin mottling score (SMS)(baseline (immediately after inclusion to the study = minute 0), minute 2, 4, 6, 8, (...) up to return of spontaneous circulation or death, whichever came first)
- Correlation of catecholamine demand during the first 48 hours after ROSC and CRT/SMS(from ROSC up to 48 hours after ROSC)
- Correlation of CRT/SMS and lactate(baseline (immediately after inclusion to the study))
- Capillary refill time (CRT)(minute 2, 4, 6, 8, (...) up to return of spontaneous circulation or death, whichever came first)
- Capillary blood lactate (Lac)(baseline (immediately after inclusion to the study, = minute 0), minute 4, 8, 12, 16, 20)
- Hospital mortality(baseline (immediately after inclusion to the study))
- Correlation of CRT, SMS and Lac and 30 days good neurological outcome(baseline (immediately after inclusion to the study))
- Correlation of CRT, SMS and Lac and hospital discharge good neurological outcome(baseline (immediately after inclusion to the study))
- Correlation of SMS and CRT(baseline (immediately after inclusion to the study))
- Correlation of time since cardiac arrest and CRT/SMS/lactate(baseline (immediately after inclusion to the study))