Neuroprognostication Using Optic Nerve Sheath Diameter

Study Overview
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Brief Summary
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This study investigates the relationship between optic nerve sheath diameter and increased intracranial pressure and its effect on neurologic outcome in post-cardiopulmonary arrest patients.

Detailed Description
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This study involves patients who have experienced either an in-hospital or out-of-hospital cardiopulmonary arrest, and who meet the 2015 American Heart Association (AHA) inclusion/exclusion criteria for targeted temperature management [i.e., they are comatose or exhibit no meaningful response to verbal commands with return of spontaneous circulation (ROSC) after cardiac arrest]. After induction of hypothermia protocol after cardiopulmonary arrest (i.e., targeted temperature management), patients will undergo ocular ultrasound at three time points.

Official Title
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Post Cardiac Arrest Neuroprognostication Using the Diameter of Optic Nerve Sheath Via Ocular ultRAsound

Conditions
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Heart Arrest, Intracranial Pressure Increase

Intervention / Treatment
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* Other: Ocular ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient ≥ 18 years of age Patient has experienced either an in-hospital or out-of-hospital cardiopulmonary arrest Patient is comatose or exhibits lack of meaningful response to verbal commands with return of spontaneous circulation (ROSC) after cardiopulmonary arrest Patient must meet all inclusion criteria as deemed by physician and the 2015 American Heart Association standards for targeted temperature management (TTM) following cardiopulmonary arrest Exclusion Criteria: Patient < 18 years of age Patient does not meet inclusion criteria for targeted temperature management (TTM) Unable to obtain consent from Legal Authorized Representative (LAR) Patient has a Do Not Resuscitate (DNR) order or a Do Not Intubate (DNI) order at the time of consent Patient has uncontrollable bleeding Patient is able to follow verbal commands Patient has another medical condition creating increased ocular pressure, as deemed by physician

Ages Eligible for Study
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Minimum Age: 18 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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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Ocular ultrasound|Post-cardiopulmonary arrest patients meeting inclusion/exclusion criteria for targeted temperature management will undergo ocular ultrasound at three time points: within 6 hours (h) of initiation of hypothermic protocol, between 10-24 h after hypothermic protocol initiation, and between 24-36 h after hypothermic protocol initiation.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Optic nerve sheath diameter | Optic nerve sheath diameter within 6 hours of hypothermic protocol initiation | 0-6 hours after hypothermic protocol initiation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Optic nerve sheath diameter | Optic nerve sheath diameter 10-24 hours after hypothermic protocol initiation | 10-24 hours after hypothermic protocol initiation | 
| Optic nerve sheath diameter | Optic nerve sheath diameter 24-36 hours after hypothermic protocol initiation | 24-36 hours after hypothermic protocol initiation |