Cardiac Arrest Clinical Trial
Official title:
Monitoring of Cerebral Oxygenation Using Jugular Oximetry in Comatose Patients After Cardiac Arrest
The use of protective ventilation (to maintain normoxia and normocapnia), optimise haemodynamics, diagnose/treat seizures, therapeutic hypotermia etc is recommended for ICU management of patients who have had cardiac arrest and remain in coma after return of spontaneous circulation according to the latest International Guidelines. These actions essentially aim to limit secondary brain injury but despite all therapeutic effort, the cerebral oxygenation may remain inadequate and there is no validated method to avoid such a state in real time.
The use of protective ventilation (to maintain normoxia and normocapnia), optimize
hemodynamics, diagnose/treat seizures, therapeutic hypothermia etc is recommended for ICU
management of patients who have had cardiac arrest and remain in a coma after the return of
spontaneous circulation according to the latest International Guidelines. These actions
essentially aim to limit secondary brain injury but despite all therapeutic effort, the
cerebral oxygenation may remain inadequate and there is no validated method to avoid such a
state in real time.
The objective of this study is to assess the relationship between jugular venous oximetry and
neurological outcome of comatose patients after cardiac arrest, evaluated as per the Cerebral
Performance Category scale (CPC). Further, the aim is to clarify relations between biomarkers
protein S100B, neuron-specific enolase (NSE) and parameters of jugular oximetry for
prognostication. An anticipated total of sixty patients will be enrolled in this
non-randomised, single-group, double-blind study.
In the course of the study, the authors have decided to stop using BIS monitoring for
sedation management. Reason for this decision was very limited reliability of this technique
in unparalyzed patients on ICU (muscle artifacts). New aim of sedation was Richmond Agitation
Sedation Scale (RASS) -4 or -5, with avoiding shivering and clinically manifested seizures.
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