Cardiac Arrest
Conditions
Keywords
In-hospital cardiac arrest, Post-cardiac arrest
Brief summary
The Discover In-Hospital Cardiac Arrest (IHCA) study is a multicenter, prospective observational study aimed at better understanding variations in practice for the post-in-hospital cardiac arrest patient.
Detailed description
There is considerable debate among experts concerning many components of intra- and post-arrest care. This study aims to increase the evidence base of these components, particularly temperature control, and prognostication in post-in-hospital cardiac arrest patients. In addition to providing insights regarding immediate and long-term post-arrest care, data collected will also be useful in studying variations in cardiopulmonary resuscitation practices. This project is endorsed by the Society of Critical Care Medicine's (SCCM) Discovery, the Critical Care Research Network.
Interventions
None listed
Sponsors
Society of Critical Care Medicine
Montefiore Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Adult (≥18 years old) patients * Patients with a cardiac arrest (a lack of palpable pulse or perfusing cardiac activity) while admitted to the hospital * Patients admitted to a ward (telemetry or non-telemetry) or an intensive care unit, or are admitted but still in the emergency department waiting for a hospital bed * Patients who achieved return of spontaneous circulation (ROSC defined as \>20 minutes of sustained spontaneous circulation) OR initiated on extracorporeal membrane oxygenation (eCPR) with chest compressions ongoing * Patients survived for 6 hours after ROSC
Exclusion criteria
* Cardiac arrest in non-inpatients (e.g. outpatients, visitors) * Patients whose cardiopulmonary resuscitation (CPR) starts outside of the hospital * Non-index arrests (arrests that are not the patient's first arrest during the hospital admission; this also excludes patients who were initially admitted for an out-of-hospital cardiac arrest) * Patients suffering IHCA in the operating room (OR) or post anesthesia care unit (PACU) * Patients with cardiac arrest after arriving to an emergency department (ED) but prior to being evaluated and admitted to the hospital * Cardiac arrests lasting \<2 minutes (i.e. chest compressions performed \<2 minutes) * Cardiac arrests where the patient is transitioned to comfort focused care within 6 hours of return of spontaneous circulation (ROSC)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fever Incidence | Up to 96-hours post cardiac arrest | The incidence of fever from ROSC until 96 hours after ROSC among patients who remain comatose |
| Multimodal Prognostication | Up to 60 days post cardiac arrest | The use of at least two approaches for prognostication prior to withdrawal of care from ROSC until hospital discharge |
| Early Withdrawal of Care | Up to 72-hours post cardiac arrest | The withdrawal of care from ROSC until 72-hour after ROSC |
Countries
United States
Outcome results
None listed