Clinical Trial Details
— Status: Terminated
Administrative data
NCT number |
NCT03237910 |
Other study ID # |
IRFMN-7167-7429 |
Secondary ID |
|
Status |
Terminated |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
April 28, 2019 |
Est. completion date |
July 26, 2021 |
Study information
Verified date |
September 2021 |
Source |
Mario Negri Institute for Pharmacological Research |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
AMSA trial is a multicenter, randomized, controlled study in out-of-hospital cardiac arrest
patients.
The purpose of the study is to test the hypothesis that a real time AMSA analysis during CPR
may predict the success of defibrillation and optimize the timing of defibrillation delivery.
The primary end-point is the efficacy of the AMSA-CPR: termination of VF/VT with achievement
of ROSC for an AMSA ≥ 15.5 mV-Hz
All patients meeting inclusion/exclusion criteria and receiving cardiopulmonary resuscitation
are randomized into two groups: AMSA-guided CPR or standard CPR.
In the AMSA-CPR group, AMSA value suggests when the rescuer should deliver the defibrillation
attempt; In the Standard-CPR group, the defibrillation is delivered based on the 2015
European Resuscitation Council (ERC) CPR guidelines.
Description:
In the AMSA-CPR intervention, upon arrival of the advanced life support (ALS) rescue team at
the cardiac arrest scene and application of the defibrillatory pads to the patient's chest
and power on of the defibrillator with the real time AMSA analysis:
- If AMSA is ≥ 15.5 mV-Hz, an immediate defibrillation is attempted, followed by CPR
- If AMSA is < 15.5 mV-Hz, defibrillation is not attempted and CPR is delivered
- During the 2-min cycle of CPR, AMSA is measured during pauses for ventilations (every 30
CC, approximately every 20/25 sec). If an AMSA value ≥ 15.5 mV-Hz is achieved prior to
cycle completion, an immediate defibrillation is delivered (thus the defibrillation
attempt is anticipated)
After completion of the first 2-min CPR cycle:
- If AMSA is ≤ 6.5 mV-Hz, the defibrillation is not attempted but CPR is continued
- If AMSA is > 6.5 mV-Hz, an immediate defibrillation attempt is delivered, followed by
CPR
- During the 2-min cycle of CPR, AMSA is measured during pauses for ventilations (every 30
CC, approximately every 20/25 sec). If an AMSA value ≥ 15.5 mV-Hz is achieved prior to
cycle completion, an immediate defibrillation is delivered
After completion of the second 2-min CPR cycle and till the end of the resuscitative
intervention:
• CPR is continued based on standard 2015 ERC guidelines (a defibrillation attempt every
2-min CPR cycles), except for the possibility to anticipate the defibrillation attempt if
AMSA becomes ≥ 15.5 mV-Hz during the CPR cycle.
In the standard CPR intervention, upon arrival of the ALS team at the cardiac arrest scene,
and application of the defibrillatory pads to the patient's chest and power on of the
defibrillator:
• a defibrillation is immediately attempted and CPR is then started and continued for 2- min.
Analysis of rhythm and subsequent defibrillation attempts are performed every 2-min CPR
cycles.
In both study groups, the quality of CC and ventilation is monitored in real time thought the
feedback integrated into the defibrillator.