Clinical trial NCT03852225: Correlation Between End-tidal CO2 and Degree of Compression of Heart During CPR Measured by Ultrasound
Official title: Correlation Between End-tidal CO2 and Degree of Compression of Heart Cavities Measured by Transthoracic Ultrasound During Cardiopulmonary Resuscitation for Out-of-hospital Cardiac Arrest
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Cardiopulmonary Resuscitation
Echocardiography
Lead sponsor: Emergency Medical Service of the Central Bohemian Region, Czech Republic
Sponsor class: OTHER
Collaborators: name: Masaryk Hospital Usti nad Labem
First posted: 2019-02-25
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All consecutive patients meeting inclusion and exclusion criteria

Brief summary: Individual optimization of cardiopulmonary resuscitation (CPR) in real time may increase the success rate of the procedure. End-tidal CO2 (EtCO2) levels reflect cardiac output induced by CPR. Other potential marker of haemodynamic efficacy of CPR is direct measurement of the extent of induced compression of left ventricle (LV), right ventricle (RV) and inferior caval vein (IVC) by ultrasound. We plane to evaluate whether these ultrasound parameters correlate with EtCO2 levels during CPR for out-of-hospital cardiac arrest (OHCA) of non-traumatic origin.

Detailed description: Pre-hospital observational study will be realized in the setting of physician-based Emergency Medical System in the Czech republic. 20 patients resuscitated for OHCA of nontraumatic origin are planned to be included to the study. Transthoracic echocardiography will be performed from subcostal view during ongoing chest compressions in all of them and in the time of this investigation EtCO2 level will be recorded. This will be repeated three times during CPR in each patient if possible. Later on, maximal and minimal diameter of LV, RV and IVC will be obtained from the recorded loops and compression index (%) of LV (LVCI), RV (RVCI) and IVC (IVCCI) will be calculated as (maximal-minimal/maximal cavital diameter)x100. Correlations between EtCO2 and LVCI, RVCI and IVCI and CImax will be expressed as Spearman's correlation coefficient.

The results of the study will answer the question whether echocardiographic evaluation of compression of heart cavities during CPR reflect haemodynamic efficacy of CPR. If so, this study will be followed by an interventional clinical trial evaluating the effect of compression depth changes as a response to measured compression of the heart.

Eligibility criteria: Inclusion Criteria:

* Adult patient resuscitated for out-of-hospital cardiac arrest of non-traumatic origin.

Exclusion Criteria:

* Technical unavailability of intra-arrest ultrasonography and capnography.

Primary outcomes:
measure: Correlation of EtCO2 level and compression index of left ventricle, right ventricle and inferior caval vein
timeFrame: Participant will be repeatedly evaluated during cardiopulmonary resuscitation. Therefore, anticipated time frame the time interval will fluctuate from 5 minutes to 120 minutes
Secondary outcomes:
Other outcomes:
Locations:
city: Kladno
country: Czechia
facility: Emergency Medical Service of the Central Bohemian Region
state: Central Bohemian Region
Study officials:
References:
citation: Skulec R, Vojtisek P, Cerny V. Correlation between end-tidal carbon dioxide and the degree of compression of heart cavities measured by transthoracic echocardiography during cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Crit Care. 2019 Oct 29;23(1):334. doi: 10.1186/s13054-019-2607-2.