Cardiac Arrest
Conditions
Brief summary
Sudden cardiac arrest (CA) is a leading cause of death worldwide. CA claims the lives of an estimated 300,000 Americans each year. Despite advances in cardiopulmonary resuscitation (CPR) methods, only approximately 10% of adults with CA survive to hospital discharge, and up to 60% of survivors have moderate to severe cognitive deficits 3 months after resuscitation. Most of the immediate and post-CA mortality and morbidity are caused by global ischemic brain injury. The goal of this grant application is to test the hypothesis that resuscitation from cardiac arrest can be improved by improving cerebral oxygenation through inhalation of nitric oxide. This strategy will also improve the chances of return of spontaneous circulation (ROSC), improve short-term survival and neurologic outcome.
Interventions
DRUGinhaled nitric oxide
Inhaled nitric oxide at 40 ppm will be administered upto 24 hours post ROSC in patient who developed in hospital cardiac arrest
Sponsors
Stony Brook University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age 18 years and above 2. In-hospital cardiac arrest as defined by cessation of heartbeat 3. Presence of Endotracheal Tube
Exclusion criteria
1. Age below 18 years 2. Absence of Endotracheal Tube 3. Patients with out-of-hospital cardiac arrest 4. Patients involved in trauma and/or patients in the SICU or CTICU 5. Preexisting intra-cerebral lesions such as any head injury (old or new), brain hematoma, cerebral hemorrhage or known frontal lobe disorders such as tumors 6. Any patient with a terminal condition that cannot be treated (specifically any terminal malignancy, end stage lung fibrosis, chronic heart failure with an ejection fraction \<20%) 7. Patients with do not resuscitate and/or do not intubate (DNR/DNI) status 8. Therapeutic window has passed
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of return of spontanueous circulation (ROSC) | 1 day | The primary outcome measure is to evaluate rates of return of spontaneous circulation (ROSC) from in hospital cardiac arrest patient who receive inhaled nitric oxide |
| Change in cerebral oxygenation (rSO2) | 1 day | The outcomes measure is to evaluate change in the concentration of cerebral oxygenation measured by Near-infrared spectroscopy before and after the administration of inhaled nitric oxide |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Neurologic outcomes at hospital discharge | upto 24 weeks | Patient who suffered in hospital cardiac arrest has variable neurologic outcomes. This will be evaluated with Glasgow outcome scale (GOS). This score ranges from 1 to 5 where GOS 1-3 is considered unfavourable neurologic outcomes and GOS 4-5 are considered favourable neurologic outcomes. |
| short term survival | upto 24 weeks | Short term survival will include survival from hospital to discharge |
Countries
United States
Contacts
Primary ContactJignesh Patel, MD
Outcome results
None listed