Cardiac Arrest Clinical Trial
Official title:
TaIwan Network of Targeted Temperature ManagEment for CARDiac Arrest Registry
The goals of the study are to establish the study cohort and database for out-of-hospital cardiac arrest patients. Indications and factors influencing the application of hypothermia treatment on cardiac arrest patients will be analyzed. The prognostic evaluation modalities under hypothermia treatment will be evaluated for their accuracy and optimal time points. These finding and results could be applied in clinical practice in the future.
The importance of cardiopulmonary resuscitation has been emphasized in recent years. The
chance of return of spontaneous circulation improves up to 70%. However, only 20 % of cardiac
arrest patients can survive to hospital discharge because of post-cardiac arrest syndrome due
to global ischemia-reperfusion injuries in cardiac arrest and resuscitation. Although there
are some studies trying to predict the survival outcomes in cardiac arrest, the prediction
variables are limited to the pre-arrest variables such as age, pre-morbidities. The impact of
these variables on long term outcomes is neither clear nor well-defined. It is found that the
chances of survival to discharge are significant different among different hospitals and
districts. It implies that the intensive managements and treatment policies could influence
the outcomes in cardiac arrest patients. However, the critical procedures or managements have
not been systemically studied and remain undefined. Targeted temperature management based on
hypothermia treatment changes the post-cardiac arrest care and improves the outcome in
cardiac arrest patients. Under hypothermia treatment, the critical time points of evaluating
prognosis are changed because of 24 hours maintaining cooling period and 12-18 hours
rewarming period. The full neurological recovery cannot be evaluated at 24 hours after return
of spontaneous circulation as the suggestion in old days without hypothermia treatment. The
optimal time points for evaluating and predicting long term outcomes need to be re-defined.
The accuracy of different modalities for outcome prediction also needed to be re-evaluated in
the hypothermia treatment era. Early and precise prediction of good recovery and favorable
outcomes are very important in determining the further intensive treatment strategies by
physicians and family for cardiac arrest patients.
The goals of the study are to establish the study cohort and database for out-of-hospital
cardiac arrest patients. Indications and factors influencing the application of hypothermia
treatment on cardiac arrest patients will be analyzed. The prognostic evaluation modalities
under hypothermia treatment will be evaluated for their accuracy and optimal time points.
These finding and results could be applied in clinical practice in the future.
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