Clinical trial NCT02056509: The Effect of Chest Compression and Ventilation Coordination During Cardiopulmonary Resuscitation.
Official title: The Effect of Chest Compression and Ventilation Coordination During Cardiopulmonary Resuscitation
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Out-of-Hospital Cardiac Arrest
Sudden Cardiac Death
Keywords: cardiopulmonary resuscitation,Ventilation
Lead sponsor: National Taiwan University Hospital
Sponsor class: OTHER
First posted: 2014-02-06
Enrollment: 50
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Cardiac arrest patient received CPR in Emergency Department Age \> 20 years old

Brief summary: Airway management and maintaining adequate ventilation during cardiopulmonary resuscitation (CPR) are important. The rule of 30:2 compression-to-ventilation ratios before endotracheal intubation and keeping 1 breath every 6-8 seconds with advanced airway are generally accepted according to 2010 Advanced Cardiac Life Support (ACLS) guideline. This recommendation emphasizes on the timing and frequency of ventilation during CPR. However, poor clinical evidence had been established concerning adequate volume, airway flow and pressure in each cycle.

There are increasing evidence that hyperventilation during resuscitation reduces pulmonary venous return and, therefore, compromises cardiac output and circulation. Another research reported that using high flow oxygen mask alone during basic life support (BLS) results in better survival rate and overall outcome compared with conventional positive pressure ventilation.

Our study applies flowmeter to measure ventilation parameters as frequency, duration, exhaled volume and airway pressure on intubated patients who received artificial ventilation during CPR. The parameters will correlate with information from accelerometry and capnometry simultaneously during resuscitation. . Investigators also focus on the influence of chest compression, which increases intra-thoracic pressure considerably. This effect may act against positive pressure ventilation and probably minimize the efficiency in each ventilation or circulation..

Details about how to ventilate one patient during CPR include right timing, duration, adequate volume and coordination are in debate. Unfortunately, current practice based on clinical guidelines emphasizes little on this issue. Investigators are committed to refine contemporary practices and hopefully improve qualities of resuscitation.

Investigators proposed the hypothesis that coordinate chest compression and ventilation may minimize the increasement of airway pressure and improve the effect of circulation


Eligibility criteria: Inclusion Criteria:

* age \> 20 years old, \< 100 years old

Exclusion Criteria:

* Trauma related out of hospital cardiac arrest

Primary outcomes:
measure: rate of 2- hour recover of spontaneous circulation
timeFrame: 2 hours
Secondary outcomes:
measure: End tidal carbon-dioxide level
timeFrame: Measured during and end of resuscitation
measure: Arterial blood gas data
timeFrame: measured during and end of resuscitaiton
measure: 30-day survival rate
timeFrame: 30 days
measure: 90-day neurologic outcome
timeFrame: 90 days
measure: Survive to discharge
timeFrame: 90 days
measure: Timing of first shockable rhythm
timeFrame: measured during resuscitaion
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: National Taiwan University Hospital
Study officials:
affiliation: Emergency department, National Taiwan University Hospital
name: Hui-Chih Wang
role: PRINCIPAL_INVESTIGATOR
References: