Clinical trial NCT06207201: Discover In-Hospital Cardiac Arrest
Official title: Discover In-Hospital Cardiac Arrest: A Prospective Multicenter Study of Post-In-Hospital Cardiac Arrest Management Practices
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Cardiac Arrest
Keywords: In-hospital cardiac arrest
Post-cardiac arrest
Lead sponsor: Montefiore Medical Center
Sponsor class: OTHER
Collaborators: name: Society of Critical Care Medicine
First posted: 2024-01-16
Enrollment: 1050
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All adult index in-hospital cardiac arrests where ROSC is achieved for \> 6 hours and the patient is not transitioned to comfort care in the first 6 hours after ROSC.

Brief summary: The Discover In-Hospital Cardiac Arrest (IHCA) study is a multicenter, prospective observational study aimed at better understanding variations in practice for the post-in-hospital cardiac arrest patient.

Detailed description: There is considerable debate among experts concerning many components of intra- and post-arrest care. This study aims to increase the evidence base of these components, particularly temperature control, and prognostication in post-in-hospital cardiac arrest patients. In addition to providing insights regarding immediate and long-term post-arrest care, data collected will also be useful in studying variations in cardiopulmonary resuscitation practices.

This project is endorsed by the Society of Critical Care Medicine's (SCCM) Discovery, the Critical Care Research Network.

Eligibility criteria: Inclusion Criteria:

* Adult (≥18 years old) patients
* Patients with a cardiac arrest (a lack of palpable pulse or perfusing cardiac activity) while admitted to the hospital
* Patients admitted to a ward (telemetry or non-telemetry) or an intensive care unit, or are admitted but still in the emergency department waiting for a hospital bed
* Patients who achieved return of spontaneous circulation (ROSC defined as \>20 minutes of sustained spontaneous circulation) OR initiated on extracorporeal membrane oxygenation (eCPR) with chest compressions ongoing
* Patients survived for 6 hours after ROSC

Exclusion Criteria:

* Cardiac arrest in non-inpatients (e.g. outpatients, visitors)
* Patients whose cardiopulmonary resuscitation (CPR) starts outside of the hospital
* Non-index arrests (arrests that are not the patient's first arrest during the hospital admission; this also excludes patients who were initially admitted for an out-of-hospital cardiac arrest)
* Patients suffering IHCA in the operating room (OR) or post anesthesia care unit (PACU)
* Patients with cardiac arrest after arriving to an emergency department (ED) but prior to being evaluated and admitted to the hospital
* Cardiac arrests lasting \<2 minutes (i.e. chest compressions performed \<2 minutes)
* Cardiac arrests where the patient is transitioned to comfort focused care within 6 hours of return of spontaneous circulation (ROSC)

Primary outcomes:
measure: Fever Incidence
timeFrame: Up to 96-hours post cardiac arrest
measure: Multimodal Prognostication
timeFrame: Up to 60 days post cardiac arrest
measure: Early Withdrawal of Care
timeFrame: Up to 72-hours post cardiac arrest
Secondary outcomes:
Other outcomes:
Locations:
city: Bronx
country: United States
facility: Montefiore Medical Center
state: New York
Study officials:
affiliation: Montefiore Medical Center
name: Ari Moskowitz, MD, MPH
role: PRINCIPAL_INVESTIGATOR
References: