Cardiac Arrest With Successful Resuscitation, Mechanical Ventilation
Conditions
Keywords
Ventilator associated event, cardiac arrest, ventilator-acquired pneumonia, ventilator associated pneumonia
Brief summary
The aim is to describe the incidence, characteristics, risk factors and outcome of complications acquired under mechanical ventilation (called ventilator-associated events) according to the new CDC criteria, in a population of patients admitted in intensive care unit after cardiac arrest.
Detailed description
Cardiac arrest (CA) survivors are frequently admitted to intensive care units. Despite improvements in management techniques, the prognosis of these patients remains poor, with mortality exceeding 90% for out-of-hospital CA and around 80% for in-hospital CA, along with a high risk of severe neurological issue. The management of these patients in intensive care requires the use of invasive mechanical ventilation. Complications occurring under mechanical ventilation have been the subject of many researches. Early bacterial pneumonia or ventilator-acquired pneumonia appears as the primary cause of respiratory worsening, and several studies have already focused on their incidence and prevention. However, studies on the benefits of antibiotic therapy or antibiotic prophylaxis for early pulmonary infections are of tricky analysis, particularly when they do not consider respiratory condition or mortality for their primary outcome measure. A new definition of complications associated with mechanical ventilation (VAEs) has been established by the Centers for Disease Control and Prevention (CDC) since 2013. It offers a more relevant tool for monitoring the impact of preventive measures on morbidity and mortality, with a more objective definition that goes beyond just tracking ventilator-associated pneumonia. Several studies have since analyzed the incidence and impact of VAEs on cohorts of intensive care patients, confirming the association between VAEs and morbidity and mortality. However, to our knowledge, none have targeted a population of cardiac arrest survivors.
Interventions
OTHERVentilator associated event
Measure of incidence of Ventilator associated event
Sponsors
Centre Hospitalier Sud Francilien
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult male or female * Non-pregnant female * Successfully resuscitated from cardiac arrest during primary care * Invasive mechanical ventilation initiated during resuscitation and continued for at least 4 days * No decision to limit life-sustaining therapies within 24 hours following admission to intensive care * No requirement of arteriovenous circulatory support during intensive care management
Exclusion criteria
\- patients who opposed to the use of their data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| number | at day 28 | Incidence of ventilator associated event |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Associated factors | at day 28 | Associated factors of ventilator associated event |
| number of pneumonias | at day 28 | Ventilator associated pneumonia according to the American Thoracic Society definition |
| time | at day 28 | Mechanical ventilation duration |
| number of deaths | at day 28 | In-hospital mortality |
Countries
France
Contacts
Primary ContactFabrice COOK, MD
Backup ContactCaroline TOURTE
Outcome results
None listed