The Impact of Aortic Valve Compression During Cardio-pulmonary Resuscitation on Patients With Out-of-hospital Cardiac Arrest

Study Overview
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Brief Summary
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Purpose: This study aims to find out if the current way of performing chest compressions during resuscitation for patients who have suffered a cardiac arrest outside of the hospital is affecting their chances of recovery. Recent research suggests that more than half of these patients receive chest compressions near their aortic valve, which might block blood flow and make their condition worse. We will use a special imaging technique called transesophageal echocardiography (TEE) during resuscitation to see if compressions near the aortic valve impact patient outcomes. Methods: We will conduct a study with patients who have suffered a cardiac arrest outside of the hospital and are receiving TEE during resuscitation in the emergency department. Some patients will not be included in the study, such as those who recover quickly before the TEE is done, those who need other treatments before they recover, those with an unclear compression site, or those with poor or missing TEE images. We will divide the patients into two groups: those with compressions near their aortic valve and those without. We will collect information on the patients, the TEE recordings, the resuscitation process, and important time points. We will mainly look at whether the patients recover and maintain a steady heartbeat. We will also examine other factors like their carbon dioxide levels, whether they recover at all, if they survive to be admitted to the hospital, if they survive to be discharged, and if they have good brain function when they leave the hospital. We plan to have 37 patients in each group for accurate results.

Official Title
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The Impact of Aortic Valve Compression During Cardio-pulmonary Resuscitation on Patients With Out-of-hospital Cardiac Arrest: A Single-center Observational Study Using Transesophageal Echocardiography

Conditions
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Out-Of-Hospital Cardiac Arrest

Intervention / Treatment
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* Device: transesophageal echocardiography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients aged 20 or older who arrived at the ED with non-traumatic OHCA and underwent TEE during resuscitation Exclusion Criteria: Early ROSC before obtaining TEE image; Insert the REBOA before ROSC; Initiate ECMO flow before ROSC; Cannot identify compression site on TEE; Poor quality of TEE image; Missing TEE image.

Ages Eligible for Study
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Minimum Age: 20 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

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| OHCA patients receiving TEE<br>Out-of-hospital cardiac arrest (OHCA) patients undergo transesophageal echocardiography (TEE) during resuscitation to determine if their aortic valve is being compressed. | Device: transesophageal echocardiography<br>* Utilizing transesophageal echocardiography (TEE) during resuscitation allows medical professionals to determine if a patient's aortic valve is being compressed while receiving chest compressions, providing valuable insight to optimize the resuscitation process.<br>* Other names: TEE;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sustained return of spontaneous circulation (ROSC) | successful restoration and maintenance of a patient's heartbeat and blood circulation after undergoing cardiopulmonary resuscitation (CPR) for at least 20 minutes | 20 minutes after ROSC | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Any return of spontaneous circulation (ROSC) |  | 1 minutes after ROSC | 
| survival to admission |  | 48 hours after ROSC | 
| survival to discharge |  | 6 months after ROSC | 
| discharge with favorable neurological outcomes |  | 6 months after ROSC | 
| end-tidal carbon dioxide (EtCO2) |  | During resuscitation |