Therapeutic Hypothermia After Cardiac Arrest in Non Shockable Rhythm

NCT ID: NCT01994772

Last Updated: 2019-01-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

584 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-26

Study Completion Date

2018-04-09

Brief Summary

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Cardiac arrest is at present a major cause of mortality as well as a cause of disability for the surviving victims.In Europe, every year counts as 300,000 cardiac arrests responsible for 250,000 deaths. Thus, less than 20 % of patients discharged home with impaired quality of life associated with symptoms of tiredness, stress, anxiety. The prognosis is related to the initial cardiac rhythm present during the initiation of resuscitation. Recent progress in the improvement of mortality and neurological outcome has been achieved over the last decade thanks to the systematic implementation of a period of targeted temperature control between 32 and 34 ° C in patients who benefited from the realization of at least one electrical external shock.

There are theoretical and clinical arguments to think that achieving the same way a period of targeted temperature control between 32 and 34 ° C in patients treated for cardiac arrest with a non- shockable rhythm on arrival can also benefit from this procedure. However other arguments are against this hypothesis including an increase in the risk of infection , worsening of the patient's hemodynamic status with no benefit to him. To answer this question, we conduce a randomized multicenter study testing the potential improvement of neurological outcome through this procedure targeted temperature control between 32.5 and 33.5 ° C in these patients.

Detailed Description

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Conditions

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Cardiac Arrest

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Targeted controlled temperature between 32.5 and 33.5°C

Patients will be placed in targeted temperature control between 32.5 and 33.5 ° C for 24 hours and then slowly rewarmed for targeted temperature control between 36.5 and 37.5 ° C for 24 hours.

Group Type ACTIVE_COMPARATOR

Targeted controlled temperature between 32.5 and 33.5°C

Intervention Type PROCEDURE

Therapeutic hypothermia ie targeted controlled temperature between 32.5° and 33.5°C will be induced in the active group. Usual method of controlled temperature will be use in ICU: internal active method or external active method.

Targeted controlled temperature between 36.5 and 37.5°C

Intervention Type PROCEDURE

Temperature was maintain between 36.5° and 37.5°C in the control group. In case of temperature superior to 37.5°C or inferior to 36.5°C, a pharmaceutical treatment and/or active cooling or warming was introduce to maintain temperature between the range of 36.5 - 37.5°C.

Targeted controlled temperature between 36.5 and 37.5°C

Patients will be placed in targeted temperature control between 36.5 and 37.5 ° C for 48 hours.

Group Type PLACEBO_COMPARATOR

Targeted controlled temperature between 36.5 and 37.5°C

Intervention Type PROCEDURE

Temperature was maintain between 36.5° and 37.5°C in the control group. In case of temperature superior to 37.5°C or inferior to 36.5°C, a pharmaceutical treatment and/or active cooling or warming was introduce to maintain temperature between the range of 36.5 - 37.5°C.

Interventions

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Targeted controlled temperature between 32.5 and 33.5°C

Therapeutic hypothermia ie targeted controlled temperature between 32.5° and 33.5°C will be induced in the active group. Usual method of controlled temperature will be use in ICU: internal active method or external active method.

Intervention Type PROCEDURE

Targeted controlled temperature between 36.5 and 37.5°C

Temperature was maintain between 36.5° and 37.5°C in the control group. In case of temperature superior to 37.5°C or inferior to 36.5°C, a pharmaceutical treatment and/or active cooling or warming was introduce to maintain temperature between the range of 36.5 - 37.5°C.

Intervention Type PROCEDURE

Other Intervention Names

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Therapeutic hypothermia Induce hypothermia Normothermia

Eligibility Criteria

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Inclusion Criteria

* Cardiac arrest in non shockable rhythm
* Glasgow score ≤ 8

Exclusion Criteria

* No flow \> 10 min
* Low flow \> 60 min
* Major hemodynamic instability
* Delay between cardiac arrest and inclusion \> 300 min
* Cirrhosis Child C
* Age \< 18 years
* Pregnant women
* Patient with no liberty
* Lack of informed consent
* Prior inclusion in a research protocol involving cardiac arrest with draw, and whose primary endpoint focuses on the evaluation of a neurological score Day 90
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Tours

OTHER

Sponsor Role collaborator

Centre Hospitalier Departemental Vendee

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean Baptiste Lascarrou, MD

Role: STUDY_CHAIR

Nantes University Hospital

Locations

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Medical Intensive Care Unit

Angers, , France

Site Status

Medical Surgical Intensive Care Unit

Angoulême, , France

Site Status

Medical Intensive Care Unit

Annecy, , France

Site Status

Medical Surgical Intensive Care Unit

Argenteuil, , France

Site Status

Medical Intensive Care Unit

Clermont-Ferrand, , France

Site Status

Medical Intensive Care Unit

Dijon, , France

Site Status

Medical Surgical Intensive Care Unit

La Roche-sur-Yon, , France

Site Status

Medical Surgical Intensive Care Unit

Le Mans, , France

Site Status

Medical Surgical Intensive Care Unit

Lens, , France

Site Status

Medical Intensive Care Unit

Lille, , France

Site Status

Medical Surgical Intensive Care Unit

Limoges, , France

Site Status

Medical Surgical Intensive Care Unit

Lorient, , France

Site Status

Medical Surgical Intensive Care Unit

Montauban, , France

Site Status

Medical Intensive Care Unit

Nantes, , France

Site Status

Medical Intensive Care Unit

Orléans, , France

Site Status

Cochin University Hospital Center

Paris, , France

Site Status

Medical Intensive Care Unit

Poitiers, , France

Site Status

Medical Surgical Intensive Care Unit

Roanne, , France

Site Status

Medical Surgical Intensive Care Unit

Rodez, , France

Site Status

Medical Surgical Intensive Care Unit

Saint-Brieuc, , France

Site Status

Medical Surgical Intensive Care Unit

Saint-Nazaire, , France

Site Status

Medical Surgical Intensive Care Unit

St-Malo, , France

Site Status

Medical Intensive Care Unit

Strasbourg, , France

Site Status

Medical Intensive Care Unit

Tours, , France

Site Status

Medical Surgical Intensive Care Unit

Versailles, , France

Site Status

CHU Pointe à Pitre

Pointe-à-Pitre, , Guadeloupe

Site Status

Countries

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France Guadeloupe

References

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Lascarrou JB, Ermel C, Cariou A, Laitio T, Kirkegaard H, Soreide E, Grejs AM, Reinikainen M, Colin G, Taccone FS, Le Gouge A, Skrifvars MB. Dysnatremia at ICU admission and functional outcome of cardiac arrest: insights from four randomised controlled trials. Crit Care. 2023 Dec 1;27(1):472. doi: 10.1186/s13054-023-04715-z.

Reference Type DERIVED
PMID: 38041177 (View on PubMed)

Ziriat I, Le Thuaut A, Colin G, Merdji H, Grillet G, Girardie P, Souweine B, Dequin PF, Boulain T, Frat JP, Asfar P, Francois B, Landais M, Plantefeve G, Quenot JP, Chakarian JC, Sirodot M, Legriel S, Massart N, Thevenin D, Desachy A, Delahaye A, Botoc V, Vimeux S, Martino F, Reignier J, Cariou A, Lascarrou JB. Outcomes of mild-to-moderate postresuscitation shock after non-shockable cardiac arrest and association with temperature management: a post hoc analysis of HYPERION trial data. Ann Intensive Care. 2022 Oct 17;12(1):96. doi: 10.1186/s13613-022-01071-z.

Reference Type DERIVED
PMID: 36251223 (View on PubMed)

Lascarrou JB, Merdji H, Le Gouge A, Colin G, Grillet G, Girardie P, Coupez E, Dequin PF, Cariou A, Boulain T, Brule N, Frat JP, Asfar P, Pichon N, Landais M, Plantefeve G, Quenot JP, Chakarian JC, Sirodot M, Legriel S, Letheulle J, Thevenin D, Desachy A, Delahaye A, Botoc V, Vimeux S, Martino F, Giraudeau B, Reignier J; CRICS-TRIGGERSEP Group. Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm. N Engl J Med. 2019 Dec 12;381(24):2327-2337. doi: 10.1056/NEJMoa1906661. Epub 2019 Oct 2.

Reference Type DERIVED
PMID: 31577396 (View on PubMed)

Lascarrou JB, Meziani F, Le Gouge A, Boulain T, Bousser J, Belliard G, Asfar P, Frat JP, Dequin PF, Gouello JP, Delahaye A, Hssain AA, Chakarian JC, Pichon N, Desachy A, Bellec F, Thevenin D, Quenot JP, Sirodot M, Labadie F, Plantefeve G, Vivier D, Girardie P, Giraudeau B, Reignier J; Clinical Research in Intensive Care and Sepsis (CRICS) Group and HYPERION Study Group. Therapeutic hypothermia after nonshockable cardiac arrest: the HYPERION multicenter, randomized, controlled, assessor-blinded, superiority trial. Scand J Trauma Resusc Emerg Med. 2015 Mar 7;23:26. doi: 10.1186/s13049-015-0103-5.

Reference Type DERIVED
PMID: 25882712 (View on PubMed)

Related Links

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Other Identifiers

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RCB 2012-A00405-38

Identifier Type: -

Identifier Source: org_study_id

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