Echocardiography, Transesophageal, Out-of-Hospital Cardiac Arrest
Conditions
Brief summary
This study shall investigate the feasibility of prehospital performed trans-esophageal echocardiography in out of hospital cardiac arrest. The investigators will include ten patients undergoing advanced life support in this study and determine if it is possible to acquire adequate trans-esophageal images within 10 minutes after arrival of the study team on scene.
Detailed description
Out of hospital cardiac arrest (OOHCA) remains a leading cause of death in Austria. Current guidelines recommend to address potentially reversible causes for OOHCA early to improve survival and some of these causes can be recognized using echocardiography. The usefulness of trans-thoracic echocardiography during OOHCA seems to be limited as image acquisition may prolong now flow time and image quality is variable. These limitations might be overcome with trans-esophageal echocardiography. The investigators will investigate the feasibility of prehospital performed trans-esophageal echocardiography in ten OOHCA patients undergoing advanced life support. In addition to routine care by paramedics and emergency physicians, a dedicated expert in emergency ultrasound will perform trans-esophageal echocardiography in these patients. Primary outcome parameter: Is it possible to obtain trans-esophageal images of the heart within 10 minutes after arrival of the study team?
Interventions
DEVICETransesophageal Echocardiography
transesophageal Echocardiography during advanced life support
Sponsors
Berufsrettung Wien
Medical University of Vienna
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DEVICE_FEASIBILITY
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adult patients undergoing advanced life support for out of hospital cardiac arrest
Exclusion criteria
* patients who should undergo rapid transport to the hospital with ongoing CPR (ECMO candidates, pregnant, trauma, obvious reversible which can be treated in hospital only) * known esophageal pathology contraindicating TEE * no definite secure airway present (endotracheal intubation, tracheostomy)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to obtain images of the heart | 10 minutes | Time from arrival of the study team on scene, until the following questions are answered by trans esophageal echocardiography: is spontaneous cardiac movement present, how ist LV function, how is RV function, is a pericardial effusion or tamponade present. The time will be measured in seconds and a maximum of 600 seconds is allowed. If answering the questions within 600 seconds is possible, the case will be counted as feasible and the duration of the time measured will be recorded. If answering the questions takes longer than 10 minutes, the case will be counted as not feasible |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hands off times | 10 minutes | what are the hands off times (defined as time during which no chest compressions are performed during the resuscitation) during ALS with or without TEE. |
| Hindering of advanced life support measures | 10 minutes | The number of events that hinder the established advanced life support measures will be counted graded by severity (minimal, minor, major) |
| Trans esophageal echocardiography related complications | 10 minutes | What complications are caused by trans esophageal echocardiography occur during ALS: displacement of the endotracheal tube, dental injury, pharyngeal injury |
| Image quality | 10 minutes | How is image quality of trans esophageal echocardiography during advanced life support measures? This will be determined by the investigator performing the trans esophageal echocardiography and also by a blinded specialist afterwards. The rating will be excellent, good, moderate, poor, extremely poor |
Countries
Austria
Contacts
Primary ContactThomas Hamp, M.D.
Outcome results
None listed