Clinical trial NCT04219384: Critical Illness Related Cardiac Arrest (CIRCA)
Official title: Critical Illness Related Cardiac Arrest (CIRCA): an Investigation of the Incidence and Outcome of Cardiac Arrest Within Intensive Care Units in the United Kingdom
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Critical Illness
Keywords: Critical Illness Related Cardiac Arrest
Lead sponsor: Intensive Care National Audit & Research Centre
Sponsor class: OTHER
Collaborators: name: North Bristol NHS Trust
First posted: 2020-01-07
Enrollment: 1800
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Adults having cardiac arrest (defined as receipt of chest compressions and/or defibrillation) after admission to an Intensive Care Unit (ICU) participating in the Case Mix Programme in a hospital participating in the National Cardiac Arrest Audit

Brief summary: CIRCA aims to determine the incidence and outcomes of in-hospital cardiac arrest (IHCA) in UK intensive care units (ICUs) and explore associated risk factors with ICU and hospital survival and quality of survival following hospital discharge.

Detailed description: Cardiac arrest is often categorised by location, out-of-hospital or in-hospital (IHCA), as there are important differences in population characteristics and aetiology. The National Cardiac Arrest Audit (NCAA) was established to audit resuscitation teams in response to IHCA, and collects information about patient characteristics, resuscitation processes, and patient outcomes. However, it does not audit IHCAs that are not attended by the resuscitation team.

Critically ill patients managed in ICUs are experiencing failure of one or more organs and therefore more intensive and invasive therapies are needed to support these failing organs. As a result, ICUs have higher nursing and medical staffing ratios, and monitoring is usually continuous. Moreover, the skill mix of the multidisciplinary team is geared to advanced life support. Thus, the risk of cardiac arrest occurring, the involvement (or not) of the resuscitation team, and the probability of return of spontaneous circulation are all likely to be different to other IHCAs.

Accurate data on cardiac arrests in ICU are lacking and the investigators do not know how many IHCA occur in ICU in the UK, nor is the impact of an IHCA in ICU on outcome known. In addition, it is not known if these IHCAs in ICUs represent an unavoidable consequence of critical illness or, more importantly, whether they can be predicted and/or prevented.

CIRCA is a prospective, multi-centre observational cohort study nested in the Case Mix Programme (CMP) and NCAA national clinical audits. The investigators aim to determine the incidence and outcomes of IHCA in UK ICUs and explore associated risk factors with ICU and hospital survival and quality of survival following hospital discharge.

Eligibility criteria: Inclusion Criteria:

1. Age 18 years old or more; and either
2. Cardiac arrest (defined as receipt of chest compressions or defibrillation) occurring while in-hospital and within intensive care (defined as either ICU, HDU or combined ICU/HDU); or
3. Family member of a patient surviving to discharge from intensive care after a cardiac arrest within ICU

Exclusion Criteria:

There are no exclusion criteria

Primary outcomes:
measure: Incidence
timeFrame: Up to 12 months
Secondary outcomes:
measure: Subsequent incidence of in-hospital cardiac arrest
timeFrame: Up to 12 months
measure: Survival status at hospital discharge
timeFrame: Up to 12 months
measure: Survival status at 12 months
timeFrame: 12 months
measure: Patient quality of life measured through EQ-5D-5L questionnaire completion at 3 months
timeFrame: 3 months
measure: Patient quality of life measured through EQ-5D-5L questionnaire completion at 6 months
timeFrame: 6 months
measure: Patient quality of life measured through EQ-5D-5L questionnaire completion at 12 months
timeFrame: 12 months
measure: Patient quality of life measured through IQCODE questionnaire completion at 3 months
timeFrame: 3 months
measure: Patient quality of life measured through IQCODE questionnaire completion at 6 months
timeFrame: 6 months
measure: Patient quality of life measured through IQCODE questionnaire completion at 12 months
timeFrame: 12 months
measure: Family member quality of life measured through FROM-16 questionnaire completion at 3 months
timeFrame: 3 months
measure: Family member quality of life measured through FROM-16 questionnaire completion at 6 months
timeFrame: 6 months
measure: Family member quality of life measured through FROM-16 questionnaire completion at 12 months
timeFrame: 12 months
Other outcomes:
Locations:
city: London
country: United Kingdom
facility: Intensive Care National Audit & Research Centre
Study officials:
affiliation: North Bristol NHS Trust
name: Matt Thomas, MD
role: PRINCIPAL_INVESTIGATOR
References: