Critically Ill, Major Trauma, Anesthesia, Emergencies
Conditions
Brief summary
Brain oxygenation of adult patients undergoing prehospital emergency anesthesia is monitored using noninvasive near-infrared spectroscopy. Patients are afterwards interviewed to define neurological outcome to measure quality of life. The purpose of this study is to reveal the risk factors of prehospital anesthesia related cerebral desaturation events (CDE) and to define the association between CDE and survival, neurological outcome or quality of life.
Interventions
DIAGNOSTIC_TESTCerebral near-infrared spectroscopy
Nonin H500 one-channel near-infrared spectroscopy monitor on forehead of the patient from before induction of anesthesia to arrival to hospital
Sponsors
FinnHEMS Ltd
Turku University Hospital
Tampere University Hospital
Oulu University Hospital
Lapland Hospital District
Kuopio University Hospital
Metropolia University of Applied Sciences
Turku University of Applied Sciences
Tampere University
Oulu University of Applied Sciences
Savonia University of Applied Sciences
Helsinki University Central Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* sedation or anesthesia provided to facilitate endotracheal intubation, performed by Helicopter Emergency Medical Services (HEMS) team regardless of the reason
Exclusion criteria
* Ongoing cardiopulmonary resuscitation at the time of intubation * Physical barrier for near-infrared spectroscopy measuring (e.g. forehead laceration) * HEMS unit does not escort patient to the hospital (exception: in case of death on scene after inclusion, patient is included) * Workload too high to ensure standard level of clinical care during the study * For interviews: no competence in Finnish, Swedish or English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Favorable neurological outcome | 30 days | modified Rankin scale ≤2 (scale 0-6, 0 asymptomatic, 6 expired) |
| Cerebral desaturation event | through prehospital care, approximately 60 minutes | an absolute drop of forehead cerebral saturation ≥ 10% from baseline for ≥ 5 minutes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Survival | 30 days | Survival |
| Favorable neurological outcome | 1 year | modified Rankin scale ≤2 (scale 0-6, 0 asymptomatic, 6 expired) |
| 15D score | 1 year | Heal-Related Quality of Life measured using 15-D instrument, scale 0-1 (0 = being dead, 0.0162 = being unconscious or comatose, 1 = no problems on any dimension = 'full' HRQOL) |
Countries
Finland
Outcome results
None listed