Clinical trial NCT00920244: In-hospital Cardiac Arrest - Dynamics and State Transitions
Official title: Dynamics and State Transitions During Resuscitation in In-hospital Cardiac Arrest
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Heart Arrest
Death, Sudden, Cardiac
Keywords: Resuscitation
Cardiac arrest
State-transitions
Markov
Lead sponsor: St. Olavs Hospital
Sponsor class: OTHER
Collaborators: name: Norwegian Air Ambulance Foundation
name: Norwegian University of Science and Technology
First posted: 2009-06-15
Enrollment: 285
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: Patients with in-hospital cardiac arrest at St.Olavs Hospital (Trondheim, Norway) during the study period.

Brief summary: The purpose of this study is to analyse transitions in cardiac rhythm and hemodynamic variables during resuscitation of patients with in-hospital cardiac arrest.

Detailed description: In-hospital cardiac arrest carries a grave prognosis, with survival to discharge in the range of 15-20%. Key factors determining outcome include the presenting cardiac rhythm, aetiology, and early initiation of resuscitation. Some cardiac rhythms benefit from defibrillation (shockable rhythms). During resuscitation patients may switch between shockable and non-shockable rhythms, and may show signs of spontaneous circulation temporarily. Depending on rhythm and according to guidelines, patients receive direct current (DC) shocks (defibrillator) and/or i.v. adrenaline, atropine and amiodarone, which may affect state-transitions. We wish to make statistical analysis (time-series analysis, Markov modelling) of these state-transitions and variations in hemodynamic variables during resuscitation, related to CPR interventions and the cause of arrest. The cause of arrest will be determined based on chart records, interview with staff and autopsy if appropriate. One hypothesis is that differences in the patterns of state-transitions may reflect underlying aetiology, which may guide in future decision-making during resuscitation.

Eligibility criteria: Inclusion Criteria:

* Patients with in-hospital cardiac arrest who are resuscitated

Exclusion Criteria:

* Younger than 18 years old

Primary outcomes:
measure: Survival to discharge
timeFrame: 1 year
Secondary outcomes:
measure: Short-term survival
timeFrame: minutes-days
Other outcomes:
Locations:
city: Trondheim
country: Norway
facility: St.Olavs Hospital, Department of Anesthesia
Study officials:
affiliation: St. Olavs Hospital
name: Eirik Skogvoll, MD, PhD
role: STUDY_CHAIR
affiliation: St. Olavs Hospital
name: Trond Nordseth, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Skjeflo GW, Nordseth T, Loennechen JP, Bergum D, Skogvoll E. ECG changes during resuscitation of patients with initial pulseless electrical activity are associated with return of spontaneous circulation. Resuscitation. 2018 Jun;127:31-36. doi: 10.1016/j.resuscitation.2018.03.039. Epub 2018 Apr 3.
citation: Nordseth T, Bergum D, Edelson DP, Olasveengen TM, Eftestol T, Wiseth R, Abella BS, Skogvoll E. Clinical state transitions during advanced life support (ALS) in in-hospital cardiac arrest. Resuscitation. 2013 Sep;84(9):1238-44. doi: 10.1016/j.resuscitation.2013.04.010. Epub 2013 Apr 19.