Post-Cardiac Arrest Syndrome Clinical Trial
Official title:
The Effect of Intra Aortic Balloon Pump Early Insertion on Mortality in Post Cardiac Arrest Patients With Acute Coronary Syndrome
The prevalence of cardiac arrests is still high worldwide. Despite the return of spontaneous
circulation (ROSC), mortality and morbidity in post cardiac arrest patients is reported high.
Comprehensive management is essential in treating patients with post cardiac arrest syndrome.
Adequate circulatory stability is achieved with fluid therapy, vasoactive drug therapy, and
consideration of mechanical support. Intra-Aortic Ballon Pump (IABP) is one of the most
feasible and available mechanical support in developing countries including Indonesia.
There are several benefits of IABP reported in acute myocardial infarction complicated with
cardiogenic shock. Nevertheless, the IABP-SHOCK II study revealed contradictive result which
is IABP support was not improving mortality in acute myocardial infarction complicated with
cardiogenic shock after revascularization. Other study, Korean Acute Myocardial Infarction
Registry (KAMIR), also reported no benefits of IABP support in cardiogenic shock patients.
But, the study the investigators mentioned earlier is a registry study, attributed to
selection bias and several confounding factors resulting mismatch in population. There are no
consideration to IABP time of initiation and duration of use in both studies.
The Investigator is aiming to prove the early insertion of IABP to a better outcome compared
with the absence of early IABP. The objective of the study is to assess mortality in post
cardiac arrest syndrome patients with early insertion of IABP support. A total of 102
subjects will be enrolled in this study, divided into IABP and non-IABP group. The primary
outcome is in-hopital-mortality, and various indicators in the pathomechanisme of post
cardiac arrest syndrome will be measured in 30 minutes and 6 hours after ROSC. Effective
lactate clearance, IL-6, Beclin-1, Caspase-3, a-vO2 diff, and ScvO2, cardiac output, VTI,
TAPSE and ejection fraction will be measured and analized between the two groups.
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