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Cardiac Arrest - ClinicalTrials.gov

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Last Updated: 10 November 2022

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Perioperative Cardiac Arrest: an Observational Mono-centre 8-year Assessment of Outcome

A perioperative heart arrest is a special occurrence of an in-hospital cardiac arrest. Adult patients' rates were estimated to be between 0. 5 - 3 percent and 2 - 10 per 10. 000 for paediatric patients, according to the spare existing data. All patients of all ages with a perioperative cardiac arrest at Bern University Hospital from 1st January 2014 to 31st December 2021 will be included by the investigators.

Source link: https://clinicaltrials.gov/ct2/show/NCT05316779


Brain Function After Cardiac Arrest (Measured With FMRI and Cognitive Tests)

Patients who are enrolled in the program will be able to answer questions regarding their health status and perform a computerized cognitive exam and a behavioral assessment on three separate occasions. The following assessments will be administered: Cognitive ability will be determined by the following questions: Attention/concentration, executive functions, memory, verbal skills, visualization, and orientation will be assessed using the Montreal Cognitive Assessment screening device, which measures attention/concentration, executive functions, executive functions, memory, verbal skills, abstract reasoning, estimation, and orientation. Using the Confusion Assessment Method for the Intensive Care Unit, the patients' medical data will be used to evaluate delirium, and it will be supplemented with evidence from their medical records. Using The Montgomery-U00c5sberg Depression Rating Scale- Self Survey and Event Scale-Revised -22, symptoms of anxiety and depression can also be measured. The following CANTAB modules will be used for this research: Delayed comparison to sample Paired associate learning test Stockings of Cambridge / One Touch Stockings of Cambridge is a general examination of whether sensorimotor impairments or ignorance will limit the collection of valid data from the participant. Patients will be treated with auditory and visual stimuli and will determine whether the stimuli given to them will be of a neutral or aversive character. morphological scans will also be included in the MRI scan. The fMRI images will be produced by blood oxygenation level dependent imaging, where differences in blood flow in different regions of the brain will be confirmed by echo planar imaging.

Source link: https://clinicaltrials.gov/ct2/show/NCT03579498


Immunoinflammatory Response in Post Cardiac Arrest Syndrome (PCAS)

According to a comparative analysis, cardiac arrest victims had more CD73+ lymphocytes than non-survivors. We also found novel populations of neutrophils that had heightened resistance to inflammatory stimuli. Following resuscitation, the investigators hypothesize that individual variation in the expression and signaling profiles of white blood cells following resuscitation affects inflammation and is independently linked to neurological outcomes. Investigators will determine the presence of various immune cell populations at various time points in patients's peripheral blood.

Source link: https://clinicaltrials.gov/ct2/show/NCT02664831


Direct or Subacute Coronary Angiography in Out-of-hospital Cardiac Arrest - a Prospective, Randomized Study

Patients with out of hospital cardiac arrest without ST-elevation on their first ECG will be randomized to either a program of immediate coronary angiography with potential coronary intervention or a program of delayed coronary angiography. Angiography with potential coronary involvement in the delayed angiography group will be carried out at the discretion of the interventional cardiologist and should not be performed until three days after the cardiac arrest.

Source link: https://clinicaltrials.gov/ct2/show/NCT02309151


Intensive Care Unit Management After Cardiac ARrest in Russia. - a Retrospective Observational Multi-center Cohort Study

The survival rate after cardiac arrest and successful CPR is about 10%, with good neurological recovery ranging from 0. 9% to 7. 8%. Heart disease is the most common cause of cardiac arrest, followed by respiratory difficulties. Adult narcotic heart arrest prevalence varies, with an average of 6 to 9 patients per 1000 hospitalizations. Adult-casual heart arrest prevalence in nosocomial cardiac arrest is different, with an average of 6 to 9 cases per 1000 hospitalizations. The European Resuscitation Council and the European Intensive Care Society's recommendations on post-resuscitation care have had a huge effect on improving the quality of care. There is also no single algorithm for the management of post-cardiac arrest syndrome, with the exception of the organ donation protocol; in the meantime, the majority of patients suffering from chronic multiple organ dysfunction in the post-resuscitation period are unlikely to be donors and die as a result of multiple organ failure's progression. Orenburg City N. I. International research and clinical center of intensive care medicine and rehabilitation, Moscow; the ICU of the Irkutsk Regional Clinical Hospital No. 1, Irkutsk City Clinical Hospital No. 1, Irkutsk City Clinical Hospital No. 1, Irkutsk City Clinical Hospital No. 1, Irkutsk; Federal research and clinical center of intensive care medicine and rehabilitation, Moscow; Orenburg Regional Clinical Hospital No. 1, Orenburg City N. The United States National surgical hospital in Krasnoyarsk interdistrict medical hospital of emergency medical care – u211620 – named after I. S. Krasnoyarsk interndistrict medical hospital, Podgorbunsky, Kemerovo; NS Karpovich, Krasnoyarsk interdistrict clinical hospital of emergency medical care; he was named after I. U. Continuous results will be published as the median and interquartile range for the nonparametric distribution, as well as the mean and standard deviation for the parametric distribution.

Source link: https://clinicaltrials.gov/ct2/show/NCT04608825


Comparison of Scores for Early Brain Damage Assessment at Intensive Care Unit Admission After Out of Hospital Cardiac Arrest

And in patients with a rapid recovery of spontaneous circulation, the result after cardiac arrest remains poor. Several studies have already shown that early interventions following ROSC, such as diagnosis of the origins, targeted temperature control, optimal hemodynamic monitoring, and extra-corporeal life support in selected patients with post-cardiac arrest patients, could improve the outcome. However, the decision process pertaining to the allocation of these funds, which also includes the care of patients' proxies, remains a difficult challenge for physicians faced with this situation. In fact, finding the right scoring system is critical to ensure optimal treatment delivery and accurate health information to families.

Source link: https://clinicaltrials.gov/ct2/show/NCT04167891


Influence of Cooling Duration on Efficacy in Cardiac Arrest Patients - A Multicenter, Randomized, Adaptive Clinical Trial to Identify the Optimal Duration of Induced Hypothermia for Neuroprotection in Comatose Survivors of Cardiac Arrest

A multicenter, randomized, adaptive allocation clinical trial to determine whether longer induced hypothermia are associated with an increasing prevalence of positive neurological outcomes and to determine the optimal duration of induced hypothermia in comatose survivors of cardiac arrest. We hypothesize that longer periods of cooling may increase the proportion of patients with a healthy neurological recovery or may result in enhanced recovery among the population that has been previously classified as having positive outcomes. In each of two groups of adult comatose survivors of cardiac arrest, the shortest period of cooling that provides the highest treatment effect is determined by a weighted 90-day adjusted Rankin score B. Secondary Goals: To characterize the effect of cooling duration and adverse events associated with it prolongation. To quantify the effect of cooling duration on patient reported quality of life. The aim of this report is to quantify the effect of cooling duration on neuropsychological outcomes. Both the proportion of subjects achieving a positive neurological result and the degree of residual functional impairment in those with stable neurological outcomes will be factored in as a weighted score. Population analysis: In the emergency department or intensive care unit, a cohort of comatose adult survivors of out of hospital cardiac arrest who have already been cooled using a specific temperature control system will be enrolled. After this initial "burn in" period, response adaptive randomization will be used to assign patients to durations ranging from 12 to 48 hours initially, and then to the 6, 60 or 72 hour time spans, according to the emerging duration-response curve. The response adaptive randomization rates for each arm will be determined separately for the two rhythm type populations. The research will be conducted by a thermo control device with closed loop feedback to a target temperature of 33 degrees C. Emergency medical service or the emergency department may begin cooling as part of routine medical services. Rewarming to a temperature of 36. 5 degrees C will occur within 24 hours or a rewarming period equal to the allocated duration of cooling. Statistical Analysis of the Primary Outcome Measure: We'll model the mean weighted mRS at 90 days in both the treatment arms. Both the proportion of subjects with a positive neurological outcome and a degree of impairment among those with healthy neurological outcomes are included in the weighted mRS. We first determine the most likely target duration, where the target duration is the shortest duration that achieves maximum treatment effect. When a normothermia control arm is not clinically acceptable, establishment of a positive duration response indicates that cooling is effective in improving outcome or recovery relative to normothermia.

Source link: https://clinicaltrials.gov/ct2/show/NCT04217551


Steroid Treatment as Anti-inflammatory and Neuroprotective Agent Following Out-of-Hospital Cardiac Arrest. A Randomized Trial

The 30-day mortality for OHCA patients revived successfully and admitted to an Intensive Care Unit is still higher than 50% thanks to a complicated systemic response referred to as the Post Cardiac Arrest Syndrome. Following resuscitation from OHCA, optimizing post-cardiac arrest care can therefore benefit optimizing post-cardiac arrest care. Inhibiting the causes of the systemic inflammatory response and, eventually, the brain injury in the early stages of resuscitation from OHCA can therefore be important to optimizing post-cardiac arrest care. As a result, resuscitated cardiac arrest patients are affected by a severe inflammation response, while the body's natural defense mechanism to regulate inflammation is suppressed. Long-term medication with glucocorticoids has a string of side effects, although short-term therapy has only minor side effects. Systemic therapy with glucocorticoids may therefore be a vital and secure component in the treatment of resuscitated cardiac arrest patients with the potential for improved survival and neurological outcomes. Methylprednisolone and other glucocorticoids are mixed in pulse doses > 250 mg/dnisolone equivalents, such as organ transplantation to avoid organ transplantation and certain rheumatic diseases with acute deterioration. Anywhere, a benefit of pulse dose glucocorticoid therapy is improved accuracy, but also a decrease in side effects as a result of a reduced demand for longer-lasting therapy spanning days or weeks. HYPOTHESIS: Bolus infusion of 250 mg methylprednisolone in the pre-hospital setting will reduce the systemic inflammation response and minimize the risk of neurological injury in comatose, according to resuscitated Out-of-Hospital Cardiac patients in the Out-of-Hospital Cardiac. The trial was conducted in the hopes of a single measurement drawn 48 hours after admission, although the investigators were unable to find evidence regarding methylprednisolone's effect on IL-6 levels or NSE levels from OHCA admission. According to the published results, the mean logarithmically improved to approximate distribution IL-6 level in 171 patients from the investigators institution after 48 hours from admission was 4. 19. 27, unpublished data. Methamphetamine, according to the investigators, would reduce the IL-6 level by 20%. After 48 hours from admission, the mean logarithmically transformed to approximate NSE level after 48 hours. The investigators expected that methylprednisolone would reduce the NSE level by 20%. If 114 patients were included, the trial would have a power of 0. 9 if 114 patients were included with u03b1-level of 0. 025. Randomization of patients will continue until a total of 120 patients have survived to blood testing at 72 hours.

Source link: https://clinicaltrials.gov/ct2/show/NCT04624776

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions