EXecution of Trans-Esophagus Echo Cardiogram in CardioPulmonary Resuscitation for Patients With Out-of-hospital Cardiac Arrest

Study Overview
=================
Brief Summary
-----------------
The purpose of this single center, randomized clinical control trial is to determine that changing chest compression site during cardiopulmonary resuscitation according to the examination of the TEE could increase the level of end-tidal CO2, which represents the quality of cardiopulmonary resuscitation, or not in adult patients with non-traumatic out-of-hospital cardiac arrest while comparing to those who don't receive examination of transesophageal echocardiography during cardiopulmonary resuscitation.

Official Title
-----------------
EXecution of Trans-Esophagus Echo Cardiogram in CardioPulmonary Resuscitation for Patients With Out-of-hospital Cardiac Arrest

Conditions
-----------------
Out-Of-Hospital Cardiac Arrest

Intervention / Treatment
-----------------
* Device: transesophageal echocardiography examination during cardiopulmonary resuscitation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age ≥ 20 years-old Out-of-hospital cardiac arrest Non-trauma Exclusion Criteria: Obvious signs of death appears, such as separation of head and body, rigor mortis, livor mortis, cankered corpse......etc. Family members clearly express the willing of do not attempt resuscitation or patients who have registered advance care planning not to attempt resuscitation. Patients not suitable for transesophageal ultrasound, such as patients with esophageal tumor, those whose probe cannot be placed......etc. While the researcher is not available.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control group<br>Perform standard advanced life support. No examination of transesophageal echocardiography during cardiopulmonary resuscitation. | |
| Experimental: Intervention group<br>Perform examination of transesophageal echocardiography during cardiopulmonary resuscitation and adjust the chest compression site to avoid left ventricular outflow tract according to the result of transesophageal echocardiography | Device: transesophageal echocardiography examination during cardiopulmonary resuscitation<br>* Perform transesophageal echocardiography in patients with out-of-hospital cardiac arrest during cardiopulmonary resuscitation and adjust the chest compression site to compress the left ventricle and avoid left ventricular outflow tract.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of 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 |
| --- | --- | --- |
| Rate of any return of spontaneous circulation | successful restoration and maintenance of a patient's heartbeat and blood circulation after undergoing cardiopulmonary resuscitation (CPR) | 1 minutes after ROSC | 
| Rate of survival to admission | successful restoration and maintenance of a patient's heartbeat and blood circulation for 48 hours | 48 hours after ROSC | 
| Rate of survival to discharge | successful restoration and maintenance of a patient's heartbeat and blood circulation and able to complete treatment course till discharge | 6 months after ROSC | 
| Rate of discharge with favorable neurological outcomes | using cerebral performance category score to measure neurologic outcomes of the patient at the time while patient's discharge. CPC1 and 2 are consider as favorable neurological outcomes, CPC3 and 4 are consider as unfavorable neurological outcomes | 6 months after ROSC | 
| end-tidal carbon dioxide (EtCO2) | measuring end-tidal carbon dioxide during resuscitation | During resuscitation | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Out-Of-Hospital Cardiac Arrest, Chest compression site, transesophageal echocardiography, end-tidal CO2