The Application of Ketamine for Sedation in Patients With Cardiac Arrest - - KetCat (KETamine in Cardiac ArresT) Study

Study Overview
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Brief Summary
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Recent evidence suggests ketamine may attenuate harmful cellular cascades taking place after brain injury that result in permanent damage. The investigators are interested in researching the application of this in the setting of cardiac arrest. Following cardiac arrest, the brain is deprived oxygen for a period of time, leading to the imitation of these harmful cellular processes. The investigators hypothesize that patients who receive ketamine as part of their standard sedation procedures during cardiac arrest treatment have better neurological functioning compared to those who do not.

Official Title
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The Application of Ketamine for Sedation in Patients With Cardiac Arrest: Feasibility, Safety, and Potential Impact on Neurological Outcomes

Conditions
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Cardiac Arrest, Out-Of-Hospital, Ketamine, Neurologic Manifestations

Intervention / Treatment
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* Drug: Ketamine Hydrochloride


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All out-of-hospital cardiac arrests (OHCA) with a shockable rhythm (ventricular fibrillation, pulseless ventricular tachycardia) that present to the Royal Columbian Hospital. The patient may be either in active cardiac arrest with shockable rhythm or may have achieved Return of Spontaneous Circulation (ROSC). Over 19 years of age Patients requiring sedation based on the assessment of the resuscitating physician. Exclusion Criteria: Any other type of cardiac arrest Any history of previous, pre-existing neurological deficit Started on Extracorporeal Membrane Oxygenation (ECMO) Duration of cardiac arrest without ROSC is greater than 30 consecutive minutes Known contraindication or hypersensitivity to ketamine Awake patient or no standard sedation or no intubation required Inability to obtain deferred consent Currently enrolled in any other research study involving drugs or devices Patients who are pregnant Patients who are prisoners Patients residing in Long Term Care (LTC) facilities

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ketamine Arm<br>Patients randomized to the ketamine arm will receive ketamine as part of their sedation medications during their cardiac arrest treatment | Drug: Ketamine Hydrochloride<br>* Parenteral General Anesthetic<br>|
| No Intervention: Control Arm<br>Patients randomized to the control arm will not receive ketamine as part of their sedation medications during their cardiac arrest treatment. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility Data | To test the appropriateness of the eligibility criteria by recording enrolment rates of eligible patients, test the randomization assignment procedures by evaluating for any difference in baseline characteristics between groups, and test adequate adherence to protocol by recording time taken to administer intervention during sedation procedures. | through study completion, an average of 6 months. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pilot Study, Single-Centre