Clinical trial NCT00951704: Evaluation of the Quality of Cardio-Pulmonary Resuscitation (CPR) in Cardiac Arrest Patients
Official title: Evaluating the Quality of Prehospital and In-hospital Cardio-pulmonary Resuscitation - Comparing the Compressions to Concurrent Vital Signs (Invasive Blood Pressure, Cerebral Oxygen Saturation, EtCO2) and Iatrogenic Injuries Associated to Chest Compressions.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Cardiac Arrest
Keywords: CPR
Tissue Perfusion
invasive arterial pressure
exhaled carbon dioxide
Quality of life
Quality of chest compressions
Epidemiology of sudden cardiac arrest(OHCA)
Lead sponsor: Tampere University Hospital
Sponsor class: OTHER
Collaborators: name: Turku University Hospital
name: Uppsala University
First posted: 2009-08-04
Enrollment: 1000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Adult population \>18 years of age with cardiac arrest

Brief summary: The prognosis of cardiac arrest patients is generally poor. Recent studies have showed that the high quality of CPR increases the survival after cardiac arrest. Therefore the investigators planned this prospective observational study to determine the epidemiology of sudden cardiac arrest in the prehospital setting of Tampere area, the quality of the CPR, and also the associations between depth and frequency of chest compressions and invasive arterial pressure, EtCO2,cerebral oxygenation and iatrogenic injuries associated to chest compressions 1) in patients resuscitated out of hospital by emergency medical service's (EMS's) personals and 2) in-hospital by hospital resuscitation team members. In addition, the investigators will analyze the effects of the chosen method of resuscitation on critical vital signs (Etco2 and invasive pressures): closed-chest CPR is compared to open-chest CPR, or mechanical CPR with a device (AutoPulse-CPR, Cardio Pump) compared to manual CPR guided with quality CPR device. The results will give the investigators important insights into the haemodynamics of CPR which may guide future strategies for the management of cardiac arrest. The research group is also interested in CPR related injuries and mattress effect. Quality of life after CA is evaluated among survivals and the cause of death among non-survivors.


Eligibility criteria: Inclusion Criteria:

* cardiac arrest
* \> 18 years of age

Exclusion Criteria:

* \< 18 years of age

Primary outcomes:
measure: The success rate of current guidelines (depth and frequency of chest compression, epidemiology)
timeFrame: During the resuscitation
measure: Quality of life after CA
timeFrame: 6 months
Secondary outcomes:
measure: Invasive arterial pressures, cerebral oxygenation (NIRS), EtCO2
timeFrame: During the resuscitation
measure: survival of cardiac arrest
timeFrame: hospital discharge
Other outcomes:
measure: Change in hemodynamics, Change in cerebral saturation, Change in quality of CPR
timeFrame: During resuscitation
Locations:
city: Tampere
country: Finland
facility: Tampere University Hospital
state: Pirkanmaa
city: Turku
country: Finland
facility: Department of Anesthesiology and Intensive Care, Turku University Hospital
Study officials:
affiliation: Critical Care Medicine Research Group
name: Jyrki Tenhunen, MD, PhD
role: STUDY_DIRECTOR
affiliation: Tampere University Hospital
name: Sanna Hoppu, MD, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Turku University Hospital
name: Marko Sainio, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Department of Anesthesiology and Intensive Care, Helsinki University Hospital
name: Klaus Olkkola, MD, PhD
role: STUDY_DIRECTOR
affiliation: Tampere University Hospital
name: Heidi Hellevuo, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Tampere University Hospital
name: Piritta Setälä, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Tampere University Hospital
name: Ilkka Virkkunen, MD, PhD
role: STUDY_DIRECTOR
affiliation: Tampere University Hospital
name: Heidi Kangasniemi, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Tampere University Hospital
name: Joonas Tamminen
role: PRINCIPAL_INVESTIGATOR
References:
citation: Kangasniemi H, Setala P, Huhtala H, Kamarainen A, Virkkunen I, Jamsen E, Yli-Hankala A, Hoppu S. Out-of-hospital cardiac arrests in nursing homes and primary care facilities in Pirkanmaa, Finland. Acta Anaesthesiol Scand. 2018 Oct;62(9):1297-1303. doi: 10.1111/aas.13152. Epub 2018 May 29.
citation: Setala P, Hellevuo H, Huhtala H, Kamarainen A, Tirkkonen J, Hoppu S. Risk factors for cardiopulmonary resuscitation-related injuries sustained during out-of-hospital cardiac arrests. Acta Anaesthesiol Scand. 2018 Oct;62(9):1290-1296. doi: 10.1111/aas.13155. Epub 2018 May 24.
citation: Setala PA, Virkkunen IT, Kamarainen AJ, Huhtala HSA, Virta JS, Yli-Hankala AM, Hoppu SE. End-tidal carbon dioxide output in manual cardiopulmonary resuscitation versus active compression-decompression device during prehospital quality controlled resuscitation: a case series study. Emerg Med J. 2018 Jul;35(7):428-432. doi: 10.1136/emermed-2017-207103. Epub 2018 May 16.
citation: Sainio M, Hoppu S, Huhtala H, Eilevstjonn J, Olkkola KT, Tenhunen J. Simultaneous beat-to-beat assessment of arterial blood pressure and quality of cardiopulmonary resuscitation in out-of-hospital and in-hospital settings. Resuscitation. 2015 Nov;96:163-9. doi: 10.1016/j.resuscitation.2015.08.004. Epub 2015 Aug 24.
citation: Sainio M, Sutton RM, Huhtala H, Eilevstjonn J, Tenhunen J, Olkkola KT, Nadkarni VM, Hoppu S. Association of arterial blood pressure and CPR quality in a child using three different compression techniques, a case report. Scand J Trauma Resusc Emerg Med. 2013 Jul 2;21:51. doi: 10.1186/1757-7241-21-51.
citation: Sainio M, Kamarainen A, Huhtala H, Aaltonen P, Tenhunen J, Olkkola KT, Hoppu S. Real-time audiovisual feedback system in a physician-staffed helicopter emergency medical service in Finland: the quality results and barriers to implementation. Scand J Trauma Resusc Emerg Med. 2013 Jul 1;21:50. doi: 10.1186/1757-7241-21-50.
citation: Hoppu S, Sainio M, Huhtala H, Eilevstjonn J, Tenhunen J, Olkkola KT. Blood pressure during resuscitation in man--the effect of pause during rhythm analysis revisited. Resuscitation. 2011 Nov;82(11):1460-3. doi: 10.1016/j.resuscitation.2011.06.005. Epub 2011 Jun 17.