Out-of-Hospital Cardiac Arrest, Pulmonary Ventilation
Conditions
Keywords
Out-of-Hospital Cardiac Arrest, Cardiopulmonary Resuscitation, Respiration, Artificial
Brief summary
The aim of this observational study is to investigate how ventilations is given during cardiopulmonary resuscitation (CPR) given by advanced life support providers (ALS). A portable device capable of detailed measurments of ventilation will be used when ventilating patients suffering cardiac arrest. The main objective of the study is to describe the ventilatiosn given in terms of volume, frequency and pressure, both overall and during different CPR modes and when using different methods to handle the patients airway.
Detailed description
The aim with this observational multicenter study is to measure and describe manual ventilation during cardiopulmonary resuscitation in the advance life support setting. Primary endpoint is the ventilation quality measured as ventilation frequency, tidal volume, minute ventilation peak inspiratory pressure and exhaled CO2. This will be studied in both asycnhronous ventilations, meaning ventilations that are given during ongoing chest compressions and syncrhonous ventilations, meaning ventilations given during a pause of the chest compressions, in a 30:2 repeatign pattern. Aditionally, airway modalities such as bag-valve-masks, Supraglottic airway devices and endotracheal tubes will be studied. The inclusion of patients will be performed at five sites, The Uppsala emergency medical services, Uppsala, Sweden, Capio AB akutläkarbilar (rapid response cars), Stockholm Sweden, Falun County hospital, Falun, Sweden, EMS Amsterdam post West, Amsterdam, The Netherlands and Lifeliner 1 HEMS, Amsterdam, The Netherlands Eligible for inclusion are patients over 18 years old suffering cardiac arrest in the areas served by the including emergency medical systems and in-hospital emergency team. The goal is to include at least 200 patients.
Interventions
DEVICEFluxmed GrH portable pneumotachograph
Fluxmed GrH portable pneumotachograph is used to measure the given ventilation. It is placed on the chosen airway adjunct and passively measures ventilation parameters such as volumes, and flow.
Sponsors
Uppsala University
Regionale Ambulance Voorziening, Amersfoort, Utrecht, Netherlands
Amsterdam UMC
Dalarna County Hospital, Falun, Sweden
Capio AB Rapid Response Cars, Stockholm, Sweden
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
Out-of-hospital cardiac arrest (OHCA) treated with CPR performed by the EMS personnel
Exclusion criteria
* Patient age \< 18 years * Known pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ventilation frequency | 1 Day | Measured as ventilations per minute. |
| Tidal volume | 1 Day | Measured as milliliters per ventilation. |
| Minute Ventilation | 1 Day | Measured as litres per minute. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Variation of etCO2 in relation to different ratios of compression to ventilations | 1 Day | etCO2 measured as kilopascal for each exhalation during CPR with 30 compressions and 2 ventilations and during continous compressions and ventilations. |
| Time of inspiration | 1 Day | Measured as seconds for each inspiration. |
| Fraction of dead space ventilation | 1 Day | Dead space measured as milliliters for each ventilation compared to the tidal volume in milliters for that same ventilation. |
| Peak inspiratory pressure during ventilation | 1 Day | Measured as cmH20 for each ventilation. |
| Return of spontaneous circulation | 1 Day | If the patient, as stated by the ALS provider, has spontaneous circultation during the resuscitation attempt |
Countries
Netherlands, Sweden
Contacts
PRINCIPAL_INVESTIGATORSten Rubertsson, PhD
Uppsala University department of surgical sciences
STUDY_CHAIRDavid Smekal, PhD
Uppsala University department of surgical sciences
STUDY_CHAIRJohan Mällberg, BsSC
Uppsala University department of surgical sciences
Outcome results
None listed