CAvent-Ventilation During Advanced Cardiopulmonary Resuscitation in Out-of-hospital Cardiac Arrest- a Descriptive Study

Study Overview
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Brief Summary
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The aim with this descriptive multicenter study is to examine the quality of the ventilation given by Emergency Medical Service (EMS) personnel during cardiopulmonary resuscitation (CPR). Primary endpoint is the ventilation quality measured as ventilation frequency, tidal volume and minute ventilation. This will primarily be studied during CPR with a 30 compression/2 ventilation ratio performed by the EMS personnel where the airway is managed with a supraglottic device but also in CPR with continuous ventilation (8-10 breaths/minute) after the airway management have been replaced with an endotracheal within the emergency room. The inclusion of patients will be performed at two sites (Uppsala; Sweden and Utrecht; Holland), all out-of-hospital cardia arrest (OHCA) patients will receive care according to current CPR guidelines using mechanical chest compressions.

Detailed Description
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The inclusion is estimated to run over a two-year period to reach the goal of at least 200 patients. The study has been preceded by a trial period in an effort to solve any logistic and technical problems. The study will be a prospective descriptive multicenter study where measurement of ventilation data will be sampled during CPR by EMS treating patients with OHCA. Any results from standard laboratory tests related to ventilation quality will be retracted from the patient medical journal systems. In addition to ventilatory variables measured as endpoints, secondary endpoints will also be outcome measures as any ROSC, survival and neurological outcome (mRS, GOS-E) measured at 30 days and at 6 months.

Official Title
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CAvent-Ventilation During Advanced Cardiopulmonary Resuscitation in Out-of-hospital Cardiac Arrest- a Descriptive Study

Conditions
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Out-of-Hospital Cardiac Arrest, Pulmonary Ventilation

Intervention / Treatment
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* Device: Fluxmed GrH will be used to measure the ventilation parameters


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Out-of-hospital cardiac arrest (OHCA) treated with CPR performed by the EMS personnel Exclusion Criteria: Patient age < 18 years Known pregnancy Trauma related cardiac arrest (inc. hanging)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Fluxmed GrH will be used to measure the ventilation parameters|The study will be a prospective descriptive multicenter study where measurement of ventilation data will be sampled during CPR by EMS treating patients with OHCA.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ventilation frequency | Measured as ventilations per minute. | From start of CPR to end of CPR. | 
| Tidal volume | Measured as milliliters per ventilation. | From start of CPR to end of CPR. | 
| Minute Ventilation | Measured as litres per minute. | From start of CPR to end of CPR. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Variation of etCO2 in relation to different ratios of compression to ventilations | etCO2 measured as kilopascal for each exhalation during CPR with 30 compressions and 2 ventilations and during continous compressions and ventilations. | From start of CPR to end of CPR. | 
| Time of inspiration | Measured as seconds for each inspiration. | From start to end of CPR. | 
| Fraction of dead space ventilation | Dead space measured as milliliters for each ventilation compared to the tidal volume in milliters for that same ventilation. | From start of CPR to end of CPR.. | 
| Peak inspiratory pressure during ventilation | Measured as cmH20 for each ventilation. | From start of CPR to end of CPR. | 
| Survival rate | Number of patients that has survived after the cardiac arrest. | 30 days post cardiac arrest | 
| Neurological outcome | Measured with the modified Ranking Scale (mRS). | 30 days post cardiac arrest | 
| Neurological outcome | Measured with the Glascow Outcome Scale -Extended (GOS-E). | 30 days post cardiac arrest. | 
| Survival rate | Number of patients that has survived after the cardiac arrest.. | 6 months post cardiac arrest | 
| Neurological outcome | Measured with the modified Ranking Scale (mRS). | 6 months post cardiac arrest | 
| Neurological outcome | Measured with the Glascow Outcome Scale -Extended (GOS-E). | 6 months post cardiac arrest. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Out-of-Hospital Cardiac Arrest, Cardiopulmonary Resuscitation, Respiration, Artificial