The Effect of Chest Compression and Ventilation Coordination During Cardiopulmonary Resuscitation.

Out-of-Hospital Cardiac Arrest Clinical Trial

Official title:

The Effect of Chest Compression and Ventilation Coordination During Cardiopulmonary Resuscitation

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT02056509
• Other study ID #: 201305100RINB
• Status: Recruiting
• Phase: N/A
• First received: January 21, 2014
• Last updated: April 1, 2015
• Start date: October 2013
• Est. completion date: July 2015

Study information

• Verified date: April 2015
• Source: National Taiwan University Hospital
• Contact: Hui-Chih Wang
• Phone: +886-2-23123456
• Email: ticoer[@]ntuh.gov.tw
• Is FDA regulated: No
• Health authority: Taiwan: Department of Health
• Study type: Observational

Clinical Trial Summary

Airway management and maintaining adequate ventilation during cardiopulmonary resuscitation (CPR) are important. The rule of 30:2 compression-to-ventilation ratios before endotracheal intubation and keeping 1 breath every 6-8 seconds with advanced airway are generally accepted according to 2010 Advanced Cardiac Life Support (ACLS) guideline. This recommendation emphasizes on the timing and frequency of ventilation during CPR. However, poor clinical evidence had been established concerning adequate volume, airway flow and pressure in each cycle.

There are increasing evidence that hyperventilation during resuscitation reduces pulmonary venous return and, therefore, compromises cardiac output and circulation. Another research reported that using high flow oxygen mask alone during basic life support (BLS) results in better survival rate and overall outcome compared with conventional positive pressure ventilation.

Our study applies flowmeter to measure ventilation parameters as frequency, duration, exhaled volume and airway pressure on intubated patients who received artificial ventilation during CPR. The parameters will correlate with information from accelerometry and capnometry simultaneously during resuscitation. . Investigators also focus on the influence of chest compression, which increases intra-thoracic pressure considerably. This effect may act against positive pressure ventilation and probably minimize the efficiency in each ventilation or circulation..

Details about how to ventilate one patient during CPR include right timing, duration, adequate volume and coordination are in debate. Unfortunately, current practice based on clinical guidelines emphasizes little on this issue. Investigators are committed to refine contemporary practices and hopefully improve qualities of resuscitation.

Investigators proposed the hypothesis that coordinate chest compression and ventilation may minimize the increasement of airway pressure and improve the effect of circulation

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: July 2015
• Est. primary completion date: February 2015
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 20 Years and older

Eligibility

Inclusion Criteria:

• age > 20 years old, < 100 years old

Exclusion Criteria:

• Trauma related out of hospital cardiac arrest

Study Design

Observational Model: Cohort, Time Perspective: Prospective

Related Conditions & MeSH terms

• Death, Sudden, Cardiac
• Heart Arrest
• Out-of-Hospital Cardiac Arrest
• Sudden Cardiac Death

Locations

Country	Name	City	State
Taiwan	National Taiwan University Hospital	Taipei

Sponsors (1)

Lead Sponsor	Collaborator
National Taiwan University Hospital

Country where clinical trial is conducted

Taiwan, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	rate of 2- hour recover of spontaneous circulation	Recover of spontaneous circulation lasting for 2 hours describe as successful recover of spontaneous circulation, otherwise failure.	2 hours	No
Secondary	End tidal carbon-dioxide level	End tidal carbon-dioxide level correlates with successful recovery of spontaneous circulation event	Measured during and end of resuscitation	No
Secondary	Arterial blood gas data	Oxygen and carbon-dioxide tension changes in different ventilation strategy in cardiopulmonary resuscitation	measured during and end of resuscitaiton	No
Secondary	30-day survival rate		30 days	No
Secondary	90-day neurologic outcome		90 days	No
Secondary	Survive to discharge	Duration of hospital stay, usually will be recorded in 90 days, occasionally will more than 90 days	90 days	No
Secondary	Timing of first shockable rhythm		measured during resuscitaion	No