Jugular Venous Oxygen Saturation During Therapeutic Hypothermia After Cardiac Arrest

NCT ID: NCT00870610

Last Updated: 2015-04-28

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 15 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2011-11-30
• Study Completion Date: 2014-12-31

Brief Summary

The purpose of this study is to understand what happens to cerebral metabolism during therapeutic hypothermia for hypoxic brain injury following cardiac arrest.

Detailed Description

Latest international guidelines recommend the use of therapeutic hypothermia in patients who have had cardiac arrest and remain in coma after return of spontaneous circulation. This is recommended essentially to limit the cerebral injury caused by cardiac arrest and possibly amplified upon reperfusion. At times, although a spontaneous circulation has returned, cerebral oxygenation may remain inadequate due to inadequate perfusion pressure, and hypothermia, by reducing cardiac output and cerebral blood flow could actually aggravate this phenomenon. The rewarming period is thought to be at greatest risk of inadequate oxygenation for the increase in metabolic demand. With this study we aim to understand what happens to cerebral oxygenation and metabolism during therapeutic hypothermia for cardiac arrest through cerebrovenous oxygen saturation monitoring and in particular, to see whether through this type of monitoring we could recognize otherwise unnoticed periods of inadequate cerebral oxygenation.

Conditions

Hypoxic Brain Injury; Hypothermia

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Interventions

retrograde jugular venous cannulation

Retrograde cannulation of jugular vein and intermittent sampling of venous blood from cerebral circulation before, during and after hypothermia.

Intervention Type: PROCEDURE

Other Intervention Names

SjO2, cerebrovenous oxygen saturation

Eligibility Criteria

Inclusion Criteria

• Adult patients in coma after cardiac arrest undergoing therapeutic hypothermia

Exclusion Criteria

• Age < 18
• Pregnancy
• Traumatic brain injury
• Contraindications to cannulation as severe coagulopathy

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 85 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Policlinico Hospital

OTHER

Sponsor Role: lead

Responsible Party

Davide Chiumello

MD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Davide Chiumello, MD

Role: PRINCIPAL_INVESTIGATOR

Fondazione Ospedale Maggiore Policlinico Mangiagalli Regina Elena

Locations

Intensive Care Unit-Fondazione Ospedale Maggiore Policlinico Mangiagalli Regina Elena

Milan, , Italy

Countries

Italy

References

Nolan JP, Morley PT, Vanden Hoek TL, Hickey RW, Kloeck WG, Billi J, Bottiger BW, Morley PT, Nolan JP, Okada K, Reyes C, Shuster M, Steen PA, Weil MH, Wenzel V, Hickey RW, Carli P, Vanden Hoek TL, Atkins D; International Liaison Committee on Resuscitation. Therapeutic hypothermia after cardiac arrest: an advisory statement by the advanced life support task force of the International Liaison Committee on Resuscitation. Circulation. 2003 Jul 8;108(1):118-21. doi: 10.1161/01.CIR.0000079019.02601.90. No abstract available.

Reference Type: BACKGROUND

PMID: 12847056 (View on PubMed)

Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002 Feb 21;346(8):557-63. doi: 10.1056/NEJMoa003289.

Reference Type: BACKGROUND

PMID: 11856794 (View on PubMed)

Macmillan CS, Andrews PJ. Cerebrovenous oxygen saturation monitoring: practical considerations and clinical relevance. Intensive Care Med. 2000 Aug;26(8):1028-36. doi: 10.1007/s001340051315.

Reference Type: BACKGROUND

PMID: 11030158 (View on PubMed)

Other Identifiers

2010

Identifier Type: -

Identifier Source: org_study_id