Cardiopulmonary Resuscitation
Conditions
Keywords
Respiration, Artificial, Advanced Cardiac Life Support, Heart Massage, Emergency Service, Hospital
Brief summary
Comparison of three ventilation modes (volume controlled, BIPAP and CPAP) during cardiopulmonary re-suscitation with a mechanical compression device in the emergency room. Primary aim is to assess mean ventilation volume in the first 15 minutes after randomization.
Detailed description
Mechanical compression devices are applied to grant continuous chest compressions and consequently blood flow during CPR (cardiopulmonary rescuscitation). Current guidelines, however, are lacking guidance of the optimal ventilation strategy in such scenarios. This may lead to lung injuries caused by high pressure levels in the chest while applying compression and ventilation simultaneously or hypoventilation. Consequently, this pilot study assesses iwhich ventilation mode is optimal. Patients will be assigned randomly to one of the three ventilation modes (Volume controlled, BiPAP-ASB, CPAP). Ventilation parameters will be continuously monitored for 15 minutes while blood gas analyses are taken as well. Further secondary outcome parameters will be assessed, e.g. hospital mortality.
Interventions
PROCEDUREPressure controlled ventilation
Pressure controlled ventilation
PROCEDURECPAP mode
CPAP mode only
PROCEDUREVolume controlled ventilation
Volume controlled ventilation mode
Sponsors
Technical University of Munich
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* On-going out of hospital CPR in the Emergency Room * Tracheal intubated * Use of mechanical chest compression device
Exclusion criteria
* If the treating team assumes that CPR will be ceased within the next 15 minutes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| mean tidal volume | Study period = 15 min (Startpoint = Activating randomized ventilation mode Endpoint = 15 minutes after Starting point or end of CPR) | mean tidal volume during the study period |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| mean minute volume | Study period = 15 min (Startpoint = Activating randomized ventilation mode Endpoint = 15 minutes after Starting point or end of CPR) | mean minute volume during the study period |
| etCO2 | Study period = 15 min (Startpoint = Activating randomized ventilation mode Endpoint = 15 minutes after Starting point or end of CPR) | Mean, final value and course of the parameter during the study period |
Other
| Measure | Time frame | Description |
|---|---|---|
| Ventilation setting change lateron | Starting after the end of Study Period (15 min after randomized ventilation mode was activated) till cardiopulmonary resuscitation is stopped by the treating team | We will assess changes made in the ventilator settings (mode, tidal volume, frequency, FiO2 and PEEP) after study period until the end of CPR |
| Ventilation hours | Starting point = Activation of randomized ventilation mode till End point = time when patient is discharged from the hospital; ; approximately 3 weeks | Ventilation hours in the hospital |
| paO2 | Study period = 15 min (Startpoint = Activating randomized ventilation mode Endpoint = 15 minutes after Starting point or end of CPR) | Mean, final value and course of the parameter during the study period |
| Hospital Survival/Mortality | Starting point = Activation of randomized ventilation mode till End point = time when patient is discharged from the hospital; approximately 3 weeks | Hospital Survival/Mortality |
| BGA | Study period = 15 min (Startpoint = Activating randomized ventilation mode Endpoint = 15 minutes after Starting point or end of CPR) | Blood gas analysis |
| 24h Survival | 24h after randomization | Survival 24h after randomization |
| paCO2 | Study period = 15 min (Startpoint = Activating randomized ventilation mode Endpoint = 15 minutes after Starting point or end of CPR) | Mean, final value and course of the parameter during the study period |
| Ventilation setting change | Study period = 15 min (Startpoint = Activating randomized ventilation mode Endpoint = 15 minutes after Starting point or end of CPR) | We will assess changes made in the ventilator settings (mode, tidal volume, frequency, FiO2 and PEEP) during the study period |
Countries
Germany
Outcome results
None listed