Accidental Hypothermia, Cardiac Arrest, Hyperkalemia
Conditions
Brief summary
Serum Potassium Rate (PR) is a key indicator for medical management of patients with accidental hypothermia particularly for hypothermia related cardiac arrest (CA). Experts recommend a cut-off value for PR of 12 mmol/l for all hypothermic victims and 8 mmol/l for avalanche casualties. Any patient presenting a PR lower than the cut-off value should be considered for Extracorporeal Rewarming. This therapeutic strategy is vital for patient survival. However, there is no consensus about what type of vessels should be punctured in order to obtain an accurate potassium rate and what type of measurement technics should be used to measure this potassium rate. The investigators hypothesize that potassium rate in these patients will differ by 1 mmol/l in blood samples collected from a peripheral vein in contrast to a central vein. The investigators study is a prospective observational, multicentre study.
Interventions
DIAGNOSTIC_TESTblood draw from three different vessels
Patient in cardiac-arrest and cold exposure, diagnostic test: blood draw from three different vessels (central vein, artery, peripheral vein) and measuring of PR
Sponsors
University Grenoble Alps
Centre Hospitalier Universitaire Vaudois
Emergency Department, Hospital of Valais, Sion
University Hospital, Grenoble
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Hypothermia related cardiac arrest * Age \> 18 years * Core temperature \< 30° C measured in oesophagus at hospital admission
Exclusion criteria
* Age \< 18 years * Known condition of pregnancy or breastfeeding women * Evidence of trauma-related cardiac arrest * Cardiac arrest in which reanimation is not justified (frozen body, final stadium of an incurable disease, advance health care directive)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of potassium rate in central venous blood and blood from a peripheral vein (measured in mmol/l) | 24 hours | Comparison of PR in central venous blood and blood from a peripheral vein (measured in mmol/l) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of potassium rate in venous and arterial blood (measured in mmol/l) | 24 hours | Comparison of potassium rate in venous and arterial blood (measured in mmol/l) |
| Comparison of potassium rate from laboratory analysis and at bedside via blood gas analyser (measured in mmol/l) | 24 hours | Comparison of potassium rate from laboratory analysis and at bedside via blood gas analyser (measured in mmol/l) |
| Comparison of the time difference between laboratory analysis and blood gas analyzer at bed side (measured in minutes) | 24 hours | Comparison of the time difference between laboratory analysis and blood gas analyzer at bed side (measured in minutes) |
| Survival and neurological outcome as measured by the Cerebral Performance Category Scale | 3 months | Survival and neurological outcome as measured by the Cerebral Performance Category Scale |
| Study of biological parameters to calculate the Strong Ion Gap (measured in mEq/l) according to the Stewart Approach | 24 hours | 1. For each sample, the apparent strong ion difference (SIDa) will be calculated as SIDa =(Na+ +K+ +Ca2+ +Mg2+)-(Cl- +Lac-) 2. The amount of weak plasma acid (A-) will be calculated as: A- = \[Alb\] × (0.123 × pH - 0.631) + \[PO4\] × (0.309 × pH - 0.469) 3. The effective strong ion difference (SIDe) will be calculated as: SIDe = 1000 × 2.46 × 10-11 × PaCO2/(10-pH) + \[A-\] To quantify unmeasured charges, the SIG will be calculated as: SIG = SIDa - SIDe |
Countries
Switzerland
Contacts
Primary ContactMarc Blancher, MD
Backup ContactSarah K Buse
Outcome results
None listed