Cardiac Arrest Clinical Trial
Official title:
Cognitive Auditory Evoked Potential After Cardiac Arrest: Interest of Mismatch negativiTY: The CAPACITY Study
Determination of vital and functional outcome in comatose survivors after cardiac arrest is principally based on the identification of predictors of non-awakening, using by clinical, biological and electrophysiological tools. In patients without presence of non-awakening predictors, it would be of interest to identify predictive criteria of awakening. The presence of mismatch negativity during the cortical auditory-evoked potential could contribute to further progress in neurological prognostication of these patients. However, at this time, its prognostic value has been insufficiently studied and the optimal time of realization remains unknown.
We hypothesized that the presence of the mismatch negativity during the cortical
auditory-evoked potential would predict a favorable outcome in comatose survivors after
cardiac arrest.The main objective is to determine the capacity of the presence of the
mismatch negativity during the cortical auditory-evoked potential to predict a 1-year
favorable outcome in comatose survivors after cardiac arrest
The secondary objectives are:
- To assess the capacity of the presence of the mismatch negativity during the cortical
auditory-evoked potential to predict awakening during the hospitalisation stay.
- To determine the optimal time of realization of the cortical auditory-evoked potential
- To determine the capacity of the presence of the mismatch negativity during the cortical
auditory-evoked potential to predict ICU discharge and/or hospital discharge favorable
outcome in comatose survivors after cardiac arrest
- To determine the impact of the sedations drugs during the hypothermia phase, and during
the ICU stay The main judgement criterion is the 1-year CPC score (CPC 1 to 2 as a
favorable outcome)
Study design : Prospective, multicentre, interventional study. Decision making to withdrawal
of life support will be strictly codified according current knowledge and standardized among
the participating centres. In the absence of predictors of non-awakening, care will be
continued without limitation. The design of the study will focus on the determination of the
capacity of the presence of the mismatch negativity during the cortical auditory-evoked
potential to predict awakening. Cortical auditory-evoked potential will be performed bedside
in the ICU by qualified neurophysiologists. Results of cortical auditory-evoked potential
will remain blinded of bedside clinicians providing care for the patients. Awakening will be
assessed bedside daily. CPC score will be evaluated at discharge of the ICU, of the hospital,
at 3 months and 1 year by an independent evaluator, blinded of the results of the cortical
auditory-evoked potentials.
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