Cardiac Arrest Clinical Trial
Official title:
The Cardiac Effects of Prolonged Hypothermia After Cardiac Arrest
This PhD study is a sub study in a randomized clinical controlled multicenter trial named
"TTH48" (ClinicalTrials.gov Identifier: NCT01689077).
The TTH48 trial examines prolonged mild therapeutic hypothermia ("MTH") at 32-34°C in 24
versus 48 hours with the primary outcome Cerebral Performance Category after 6 month in
comatose out-of-hospital cardiac arrest patients.
THE OVERALL AIM OF THIS PhD STUDY IS TO INVESTIGATE THE CARDIAC FUNCTION AND THE
HEMODYNAMICS BY BIOCHEMICAL CARDIAC MARKERS, ECHOCARDIOGRAPHY, BY ANALYZING THE USAGE OF
INOTROPES/VASOPRESSORS AND BY ANALYZING ECG DATA FOR ARRHYTHMIAS IN THE 24 VERSUS 48 HOURS
MTH GROUPS.
The PhD-study contains 3 sub studies:
- Study 1 estimates the extend of myocardial damage resulting from the primary arrest and
from the reperfusion injuries: Area under the curve of cTnT and CK-MB as 12 repeated
measurements and NT-proBNP as 4 measurements post arrest
-Hypothesis: There is a statistically significantly greater release of the cardiac
biomarkers cTnT and NT-proBNP quantified by the area under the curve in the 24 versus
the 48 hours group in the intervention period from 24 to 72 hours.
- Study 2 investigates MTH´s influence on systolic and diastolic function by standard and
Tissue Doppler (TDI) echocardiography after 24, 48 and 72 hours. The primary endpoint
is mitral annular systolic velocity ("S´ max")
-Primary hypothesis: There is statistically significant improvement in S' max from the
time T24 to T72 in the 48 versus the 24 hours group.
-Secondary hypothesis: There is statistically significantly better systolic function at
T48 measured in terms of individual S' max-change in the 48 hours group (still
hypothermic) versus the 24 hours group (reached normothermia).
- Study 3 investigates MTH´s influence on the need for vasopressor or inotrope and the
duration of arrhythmias during the first 72 hours post arrest.
- Primary hypothesis: There is a statistically significantly increased tendency of
arrhythmias in the 48 versus the 24 hours group measured in the period from T0 to
T72.
- Secondary hypothesis: There is a statistically significantly reduced need for
inotropes in the 48 versus the 24 hours group measured by cumulative vasopressor
index in the period from T0 to T72.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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