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
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
Recruitment Status
TERMINATED
Clinical Phase
NA
Total Enrollment
14 participants
Study Classification
INTERVENTIONAL
Study Start Date
2020-06-12
Study Completion Date
2022-12-30
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
The PERSEUS protocol is a new approach to the resuscitation of highly monitored patients with cardiac arrest. It aims at the optimization of all the available physiological parameters and the full exploitation of both the "cardiac pump" and "thoracic pump'. This protocol will help to titrate chest compressions, ventilation, and vasopressor dosing to physiological parameters, increasing survival after cardiac arrest with favorable neurological outcome
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
The Effect of SPecialty cAre on Recovery From Cardiac Arrest Trial (the SPARC Trial)
NCT07002294
Cardiac Arrest (CA)
Heart Arrest
Heart Arrest, Out-Of-Hospital
NOT_YET_RECRUITING
NA
Pre-hospital ECMO or Conventional Resuscitation for Refractory Cardiac Arrest
NCT06177730
Out of Hospital Cardiac Arrest
NOT_YET_RECRUITING
NA
Plasma-Lyte 148® versUs Saline Study
NCT02721654
Hypovolemia
COMPLETED
PHASE4
A Randomised Trial of Expedited Transfer to a Cardiac Arrest Centre for Non-ST Elevation Out-of-hospital Cardiac Arrest
NCT03872960
Out-Of-Hospital Cardiac Arrest
COMPLETED
NA
RApid Fluid Volume EXpansion in Patients in Shock After the Initial Phase of Resuscitation.
NCT02645851
Shock
Hypovolemia
TERMINATED
NA
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
BACKGROUND
Since 2000, resuscitation guidelines remain uniform across all cardiac arrest patients, focusing on the delivery of chest compressions to a standardized rate and depth and algorithmic vasopressor dosing. Although the concept of goal-directed hemodynamic optimization as a treatment strategy to improve clinical outcome in critically ill patients has been tested since the 1980s, no human study has established that prospectively targeting hemodynamics during CPR improves outcomes until now. Nevertheless, individualizing resuscitation to the appropriate hemodynamic and ventilatory goals rather than a standard Bone-size-fits-all treatment seems a promising new therapeutic strategy that can be applied during resuscitation attempts in highly monitored patients.
The PERSEUS protocol is a new approach to the resuscitation of highly monitored patients with cardiac arrest. It has been developed based on our experience and the observation that the most important determinant of survival is the optimization of all the available physiological parameters and the full exploitation of both the "cardiac pump" and "thoracic pump'.
Physiological and pathophysiological aspects of cardiac arrest Cardiac arrest interval Immediately after the abrupt loss of effective blood flow, the hypotension-induced baroreflex withdrawal with the net increase in the vascular resistance maintains an impaired antegrade and pulmonary blood flow. The systemic and pulmonary blood flow continue for at least 30-60 s, until the pressure gradient between the aorta and the right side of the heart, as well as between the pulmonary artery and the left atrium, has been completely dissipated, resulting in a rapid increase in the volume of the right ventricle and the extrapericardial component of the pulmonary veins. When arterial and systemic venous pressures reach equilibrium, the mean systemic filling pressure (Pmsf) is approximately 6-12 mmHg. The coronary blood flow declines to zero, but CPP remains positive because of the retrograde coronary flow. However, this diminishes the removal of norepinephrine from the interstitial spaces, which together with the formation of cardiac edema prolongs vasoconstriction and enhances myocardial hypoperfusion and hypoxia.
At the same time, cerebral perfusion decreases while the damage of fatty acids of the neuronal cell membrane by reactive oxygen species leads to a progressive increase in membrane permeability and severe derangements of intracellular electrolytes, resulting in cell swelling and brain edema formation. This, together with venous congestion, increases intracranial pressure (ICP) and damages the neuropil and synaptic structures and/or contacts.
The PERSEUS personalized physiology-guided resuscitation protocol Recognizing cardiac arrest in highly monitored areas can be more difficult than in other hospital areas, such as the ward. Considering that the vast majority of alarms from sensors are false alarms, cardiac arrest should be recognized and confirmed by the combined assessment of the rhythm, the arterial blood pressure and waveform, the abrupt decrease of ETCO2, and the loss of carotid pulse. Once cardiac arrest is confirmed, CPR should be initiated without delay with high-quality chest compressions according to the recent resuscitation guidelines. However, the effectiveness of chest compressions is depending on the venous return, which is proportional to the pressure gradient between Pmsf and CVP, and particular attention is needed by the rescuers to determine Pmsf within the first 5-7.5 s of cardiac arrest and prior to the onset of chest compressions. The Pmsf is a quantitative measurement of the patient's volume status and represents the tone of venous reservoir, indicating the pre-arrest "vasoreactivity" status of the patients. Therefore, optimizing Pmsf during CPR is paramount for increasing survival rates.
During the first cycle of CPR, the resuscitation efforts must maintain a relaxation DAP of ≥ 40 mmHg (calculated at the time of full chest decompression). In patients with a lower DAP, administration of epinephrine or vasopressin should be based on the pre-arrest value of Pmsf and/or systemic vascular resistance (SVR) and is anticipated to be beneficial in those with Pmsf \< 6 mmHg and/or SVR \< 800 dynes·sec·cm-5, enhancing volume recruitment from the unstressed compartment and increasing the stressed volume. In all other patients, the vasoreactivity will be maintained for some time provided that intravascular volume and chest compressions are sufficient. Therefore, circulatory volume should be increased in patients with a pre-arrest CVP \< 2 mmHg using a fluid bolus and/or the passive leg-raising maneuver. However, it should be noted that rapid and liberal fluid administration during CPR may lead to an excessive increase in RAP, aggravating venous return and CPP, especially when administered via a jugular or subclavian central venous catheter. At the onset of cardiac arrest, ventilatory parameters should be changed to tidal volume 6 ml/kg, respiratory rate 10 min-1, I:E 1:2, PEEP 0 cm H20, and FiO2 100%. During this cycle, all other treatment efforts must follow current recommendations for standard CPR.
After the onset of the second cycle of CPR, the resuscitation efforts should be continued as above while assessing ETCO2. As stated previously, ventilation during CPR by using currently recommended chest compression rates may take place entirely below functional residual capacity and may not provide adequate blood oxygenation due to small airway closure, increasing pulmonary vascular resistance and impairing gas exchange. Therefore, mean airway pressure should be maintained 40-45 cmH2O in patients with DAP ≥ 40 mmHg and ETCO2 \< 10 mmHg to facilitate gas exchange. On the contrary, all patients with DAP \> 40 mmHg and ETCO2 \> 15 mmHg should be assessed for hypercapnia, and if present, they should be treated by increasing the ventilatory rate by up to 50% (or less if necessary to maintain DAP ≥ 40 mmHg). Also, severe acidosis should be treated immediately because it causes vasodilatation which may decrease venous return and CPP.
During the third cycle of CPR, the resuscitation efforts should be continued as above while assessing ScvO2, which should be maintained 65-80%. In patients with ScvO2 \< 65%, transfusion of red blood cells should be initiated when Hb is ≤8 g/dl to improve oxygen delivery. In patients with Hb \> 8 g/dl, a fluid bolus should be given to improve circulatory flow provided that DAP is maintained ≥ 40 mmHg. In patients with DAP ≥ 40 mmHg and a ScvO2 value of \> 80%, hypothermia should be excluded and treated aggressively if present, the FiO2 should be decreased in case of hyperoxemia (PaO2 \> 200 mmHg), and a low-dose vasodilator may be considered when microcirculatory shunting and loss of hemodynamic coherence between macro- and microcirculation can be directly assessed or possible (e.g., DAP ≥ 40 mmHg, Hb \> 8 g/dl, PaO2 \> 200 mmHg, ScvO2 \> 80%, and mixed venous oxygen tension ≤ 26 mmHg (if available), with or without hyperlactatemia). In patients with normal ScvO2, trend cerebral oxygenation monitoring (near-infrared spectroscopy - NIRS) should be used because it focuses more on the amount of change from the pre-arrest baseline cerebral oxygenation value. Decreasing FiO2 until PaO2 is 200 mmHg can be considered when NIRS is \> 50% of the prearrest value, while HUP-CPR (30°) should be considered in patients with NIRS ≤ 30% of the pre-arrest value and signs or known increased intracranial pressure. The resuscitation efforts may be considered as adequate in patients who have reached the pre-defined targets and have a NIRS of 30-50% of the pre-arrest value, and should be continued by repeating the approach from the beginning.
AIM
The PERSEUS resuscitation protocol is a new approach to the resuscitation of highly monitored patients with cardiac arrest and may help to titrate chest compressions, ventilation, and vasopressor dosing to physiological parameters. The aim of this double-center study is to investigate if resuscitation with the PERSEUS protocol can increase survival after cardiac arrest with favorable neurological outcome.
METHODS
Design This is a prospective observational study designed in accordance with the declaration of Helsinki. The study will be register at Clinical Trials.gov and has been approved by the Institutional Review Board of the University Hospital of Larisa, under the reference number 2670/3-2-2020.
Patient eligibility All intubated and mechanically ventilated adult patients (≥ 18 years of age) with a CPR event requiring chest compressions in a highly monitored area \[Operating Room, Intensive Care Unit (ICU), or Emergency Department\] will be eligible for inclusion. Each patient will be allocated into two groups; patients in group A will be resuscitated with the PERSEUS protocol, while patients in group B will receive standard CPR according to the latest European Resuscitation Council guidelines on resuscitation. Random allocation will be carried out by a researcher who will not be involved in data collection using the sealed envelope technique.
Data Collection and Monitoring Data analysis will be based on predefined data points on a prospective data collection form. The staff will be blinded to measurements until the end of the study and all data are analyzed. Clinical monitoring throughout the study will be performed to maximize protocol adherence, while an independent Data and Safety Monitoring research staff will monitor safety, ethical, and scientific aspects of the study.
We will use the Utstein-style templates for in-hospital cardiac arrest data. Return of spontaneous circulation will be defined for all rhythms as the restoration of a spontaneous perfusing rhythm for more than 20 minutes. Survival with a favorable neurological outcome will be defined as a cerebral performance category (CPC) score of 1, 2 or no change from baseline. The CPC scoring system assesses functional outcomes among survivors of cardiac arrest and has been extensively validated and shown to reliably predict functional neurological disability.
Data management The goal of the clinical data management plan is to provide high-quality data by adopting standardized procedures to minimize the number of errors and missing data, and consequently, to generate an accurate database for analysis. Remote monitoring is performed to signal early aberrant patterns, issues with consistency, credibility and other anomalies. Any missing and outlier data values will individually revised and completed or corrected whenever possible.
Ethics and dissemination The study will be performed according to national and international guidelines. The present research investigation was reviewed by the IRB at the Larisa University Hospital and determined to be IRB exempt.
Competing interests None declared.
Since 2000, resuscitation guidelines remain uniform across all cardiac arrest patients, focusing on the delivery of chest compressions to a standardized rate and depth and algorithmic vasopressor dosing. Although the concept of goal-directed hemodynamic optimization as a treatment strategy to improve clinical outcome in critically ill patients has been tested since the 1980s, no human study has established that prospectively targeting hemodynamics during CPR improves outcomes until now. Nevertheless, individualizing resuscitation to the appropriate hemodynamic and ventilatory goals rather than a standard Bone-size-fits-all treatment seems a promising new therapeutic strategy that can be applied during resuscitation attempts in highly monitored patients.
The PERSEUS protocol is a new approach to the resuscitation of highly monitored patients with cardiac arrest. It has been developed based on our experience and the observation that the most important determinant of survival is the optimization of all the available physiological parameters and the full exploitation of both the "cardiac pump" and "thoracic pump'.
Physiological and pathophysiological aspects of cardiac arrest Cardiac arrest interval Immediately after the abrupt loss of effective blood flow, the hypotension-induced baroreflex withdrawal with the net increase in the vascular resistance maintains an impaired antegrade and pulmonary blood flow. The systemic and pulmonary blood flow continue for at least 30-60 s, until the pressure gradient between the aorta and the right side of the heart, as well as between the pulmonary artery and the left atrium, has been completely dissipated, resulting in a rapid increase in the volume of the right ventricle and the extrapericardial component of the pulmonary veins. When arterial and systemic venous pressures reach equilibrium, the mean systemic filling pressure (Pmsf) is approximately 6-12 mmHg. The coronary blood flow declines to zero, but CPP remains positive because of the retrograde coronary flow. However, this diminishes the removal of norepinephrine from the interstitial spaces, which together with the formation of cardiac edema prolongs vasoconstriction and enhances myocardial hypoperfusion and hypoxia.
At the same time, cerebral perfusion decreases while the damage of fatty acids of the neuronal cell membrane by reactive oxygen species leads to a progressive increase in membrane permeability and severe derangements of intracellular electrolytes, resulting in cell swelling and brain edema formation. This, together with venous congestion, increases intracranial pressure (ICP) and damages the neuropil and synaptic structures and/or contacts.
The PERSEUS personalized physiology-guided resuscitation protocol Recognizing cardiac arrest in highly monitored areas can be more difficult than in other hospital areas, such as the ward. Considering that the vast majority of alarms from sensors are false alarms, cardiac arrest should be recognized and confirmed by the combined assessment of the rhythm, the arterial blood pressure and waveform, the abrupt decrease of ETCO2, and the loss of carotid pulse. Once cardiac arrest is confirmed, CPR should be initiated without delay with high-quality chest compressions according to the recent resuscitation guidelines. However, the effectiveness of chest compressions is depending on the venous return, which is proportional to the pressure gradient between Pmsf and CVP, and particular attention is needed by the rescuers to determine Pmsf within the first 5-7.5 s of cardiac arrest and prior to the onset of chest compressions. The Pmsf is a quantitative measurement of the patient's volume status and represents the tone of venous reservoir, indicating the pre-arrest "vasoreactivity" status of the patients. Therefore, optimizing Pmsf during CPR is paramount for increasing survival rates.
During the first cycle of CPR, the resuscitation efforts must maintain a relaxation DAP of ≥ 40 mmHg (calculated at the time of full chest decompression). In patients with a lower DAP, administration of epinephrine or vasopressin should be based on the pre-arrest value of Pmsf and/or systemic vascular resistance (SVR) and is anticipated to be beneficial in those with Pmsf \< 6 mmHg and/or SVR \< 800 dynes·sec·cm-5, enhancing volume recruitment from the unstressed compartment and increasing the stressed volume. In all other patients, the vasoreactivity will be maintained for some time provided that intravascular volume and chest compressions are sufficient. Therefore, circulatory volume should be increased in patients with a pre-arrest CVP \< 2 mmHg using a fluid bolus and/or the passive leg-raising maneuver. However, it should be noted that rapid and liberal fluid administration during CPR may lead to an excessive increase in RAP, aggravating venous return and CPP, especially when administered via a jugular or subclavian central venous catheter. At the onset of cardiac arrest, ventilatory parameters should be changed to tidal volume 6 ml/kg, respiratory rate 10 min-1, I:E 1:2, PEEP 0 cm H20, and FiO2 100%. During this cycle, all other treatment efforts must follow current recommendations for standard CPR.
After the onset of the second cycle of CPR, the resuscitation efforts should be continued as above while assessing ETCO2. As stated previously, ventilation during CPR by using currently recommended chest compression rates may take place entirely below functional residual capacity and may not provide adequate blood oxygenation due to small airway closure, increasing pulmonary vascular resistance and impairing gas exchange. Therefore, mean airway pressure should be maintained 40-45 cmH2O in patients with DAP ≥ 40 mmHg and ETCO2 \< 10 mmHg to facilitate gas exchange. On the contrary, all patients with DAP \> 40 mmHg and ETCO2 \> 15 mmHg should be assessed for hypercapnia, and if present, they should be treated by increasing the ventilatory rate by up to 50% (or less if necessary to maintain DAP ≥ 40 mmHg). Also, severe acidosis should be treated immediately because it causes vasodilatation which may decrease venous return and CPP.
During the third cycle of CPR, the resuscitation efforts should be continued as above while assessing ScvO2, which should be maintained 65-80%. In patients with ScvO2 \< 65%, transfusion of red blood cells should be initiated when Hb is ≤8 g/dl to improve oxygen delivery. In patients with Hb \> 8 g/dl, a fluid bolus should be given to improve circulatory flow provided that DAP is maintained ≥ 40 mmHg. In patients with DAP ≥ 40 mmHg and a ScvO2 value of \> 80%, hypothermia should be excluded and treated aggressively if present, the FiO2 should be decreased in case of hyperoxemia (PaO2 \> 200 mmHg), and a low-dose vasodilator may be considered when microcirculatory shunting and loss of hemodynamic coherence between macro- and microcirculation can be directly assessed or possible (e.g., DAP ≥ 40 mmHg, Hb \> 8 g/dl, PaO2 \> 200 mmHg, ScvO2 \> 80%, and mixed venous oxygen tension ≤ 26 mmHg (if available), with or without hyperlactatemia). In patients with normal ScvO2, trend cerebral oxygenation monitoring (near-infrared spectroscopy - NIRS) should be used because it focuses more on the amount of change from the pre-arrest baseline cerebral oxygenation value. Decreasing FiO2 until PaO2 is 200 mmHg can be considered when NIRS is \> 50% of the prearrest value, while HUP-CPR (30°) should be considered in patients with NIRS ≤ 30% of the pre-arrest value and signs or known increased intracranial pressure. The resuscitation efforts may be considered as adequate in patients who have reached the pre-defined targets and have a NIRS of 30-50% of the pre-arrest value, and should be continued by repeating the approach from the beginning.
AIM
The PERSEUS resuscitation protocol is a new approach to the resuscitation of highly monitored patients with cardiac arrest and may help to titrate chest compressions, ventilation, and vasopressor dosing to physiological parameters. The aim of this double-center study is to investigate if resuscitation with the PERSEUS protocol can increase survival after cardiac arrest with favorable neurological outcome.
METHODS
Design This is a prospective observational study designed in accordance with the declaration of Helsinki. The study will be register at Clinical Trials.gov and has been approved by the Institutional Review Board of the University Hospital of Larisa, under the reference number 2670/3-2-2020.
Patient eligibility All intubated and mechanically ventilated adult patients (≥ 18 years of age) with a CPR event requiring chest compressions in a highly monitored area \[Operating Room, Intensive Care Unit (ICU), or Emergency Department\] will be eligible for inclusion. Each patient will be allocated into two groups; patients in group A will be resuscitated with the PERSEUS protocol, while patients in group B will receive standard CPR according to the latest European Resuscitation Council guidelines on resuscitation. Random allocation will be carried out by a researcher who will not be involved in data collection using the sealed envelope technique.
Data Collection and Monitoring Data analysis will be based on predefined data points on a prospective data collection form. The staff will be blinded to measurements until the end of the study and all data are analyzed. Clinical monitoring throughout the study will be performed to maximize protocol adherence, while an independent Data and Safety Monitoring research staff will monitor safety, ethical, and scientific aspects of the study.
We will use the Utstein-style templates for in-hospital cardiac arrest data. Return of spontaneous circulation will be defined for all rhythms as the restoration of a spontaneous perfusing rhythm for more than 20 minutes. Survival with a favorable neurological outcome will be defined as a cerebral performance category (CPC) score of 1, 2 or no change from baseline. The CPC scoring system assesses functional outcomes among survivors of cardiac arrest and has been extensively validated and shown to reliably predict functional neurological disability.
Data management The goal of the clinical data management plan is to provide high-quality data by adopting standardized procedures to minimize the number of errors and missing data, and consequently, to generate an accurate database for analysis. Remote monitoring is performed to signal early aberrant patterns, issues with consistency, credibility and other anomalies. Any missing and outlier data values will individually revised and completed or corrected whenever possible.
Ethics and dissemination The study will be performed according to national and international guidelines. The present research investigation was reviewed by the IRB at the Larisa University Hospital and determined to be IRB exempt.
Competing interests None declared.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Cardiac Arrest
Cardiopulmonary Arrest With Successful Resuscitation
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
TREATMENT
Blinding Strategy
DOUBLE
Participants
Outcome Assessors
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
PERSEUS CPR
Patients will be resuscitated according to the PERSEUS protocol
Group Type
EXPERIMENTAL
PERSEUS CPR
Intervention Type
OTHER
Resuscitation based on patient physiology
CONTROL
Patients will be resuscitated according to current Advanced Life Support guidelines
Group Type
ACTIVE_COMPARATOR
Standard CPR
Intervention Type
OTHER
Resuscitation based on current guidelines
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
PERSEUS CPR
Resuscitation based on patient physiology
Intervention Type
OTHER
Standard CPR
Resuscitation based on current guidelines
Intervention Type
OTHER
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* invasive arterial blood pressure monitoring prior to and during CPR
* first compression of CPR captured on transmitted arterial blood pressure waveform data
* internal jugular or subclavian central venous catheter prior to and during CPR
* patients with measurement of systemic vascular resistance prior to and during CPR
* first compression of CPR captured on transmitted arterial blood pressure waveform data
* internal jugular or subclavian central venous catheter prior to and during CPR
* patients with measurement of systemic vascular resistance prior to and during CPR
Exclusion Criteria
* unable to determine any of the aforementioned parameters during CPR
* unable to determine when CPR started and stopped
* subjects within the exclusion period of another study
* unable to determine when CPR started and stopped
* subjects within the exclusion period of another study
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
University of Thessaly
OTHER
Sponsor Role
lead
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Athanasios Chalkias, MD, PhD
Assistant Professor of Anesthesiology
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Athanasios Chalkias, MD, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Thessaly
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
University Hospital of Larisa, Department of Anesthesiology
Larissa, Thessaly, Greece
Site Status
Countries
Review the countries where the study has at least one active or historical site.
Greece
References
Explore related publications, articles, or registry entries linked to this study.
Sutton RM, French B, Meaney PA, Topjian AA, Parshuram CS, Edelson DP, Schexnayder S, Abella BS, Merchant RM, Bembea M, Berg RA, Nadkarni VM; American Heart Association's Get With The Guidelines-Resuscitation Investigators. Physiologic monitoring of CPR quality during adult cardiac arrest: A propensity-matched cohort study. Resuscitation. 2016 Sep;106:76-82. doi: 10.1016/j.resuscitation.2016.06.018. Epub 2016 Jun 24.
Reference Type
BACKGROUND
Jellinek H, Krenn H, Oczenski W, Veit F, Schwarz S, Fitzgerald RD. Influence of positive airway pressure on the pressure gradient for venous return in humans. J Appl Physiol (1985). 2000 Mar;88(3):926-32. doi: 10.1152/jappl.2000.88.3.926.
Reference Type
BACKGROUND
Aya HD, Cecconi M. Can (and should) the venous tone be monitored at the bedside? Curr Opin Crit Care. 2015 Jun;21(3):240-4. doi: 10.1097/MCC.0000000000000199.
Reference Type
BACKGROUND
Berg RA, Sutton RM, Reeder RW, Berger JT, Newth CJ, Carcillo JA, McQuillen PS, Meert KL, Yates AR, Harrison RE, Moler FW, Pollack MM, Carpenter TC, Wessel DL, Jenkins TL, Notterman DA, Holubkov R, Tamburro RF, Dean JM, Nadkarni VM; Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) PICqCPR (Pediatric Intensive Care Quality of Cardio-Pulmonary Resuscitation) Investigators. Association Between Diastolic Blood Pressure During Pediatric In-Hospital Cardiopulmonary Resuscitation and Survival. Circulation. 2018 Apr 24;137(17):1784-1795. doi: 10.1161/CIRCULATIONAHA.117.032270. Epub 2017 Dec 26.
Reference Type
BACKGROUND
Chalkias A, Xanthos T. Timing positive-pressure ventilation during chest compression: the key to improving the thoracic pump? Eur Heart J Acute Cardiovasc Care. 2015 Feb;4(1):24-7. doi: 10.1177/2048872613516923. Epub 2013 Dec 12.
Reference Type
BACKGROUND
Chalkias A, Pavlopoulos F, Koutsovasilis A, d'Aloja E, Xanthos T. Airway pressure and outcome of out-of-hospital cardiac arrest: A prospective observational study. Resuscitation. 2017 Jan;110:101-106. doi: 10.1016/j.resuscitation.2016.10.023. Epub 2016 Nov 10.
Reference Type
BACKGROUND
Chalkias A, Arnaoutoglou E, Xanthos T. Personalized physiology-guided resuscitation in highly monitored patients with cardiac arrest-the PERSEUS resuscitation protocol. Heart Fail Rev. 2019 Jul;24(4):473-480. doi: 10.1007/s10741-019-09772-7.
Reference Type
BACKGROUND
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
UTHDA-AC02
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.
Priming of Cardiopulmonary Bypass With Hydroxyethyl Starch 130/0.4 or Sodium Chloride 0.9% : Pilot Study in Adult Elective Conventional Cardiac Surgery
NCT02906514
COMPLETED
PHASE3
AMCPR (Augmented-Medication CardioPulmonary Resuscitation) Trial for OHCA
NCT03191240
COMPLETED
PHASE2
The Effect Of Resuscitation Guided By Two Different Dynamic Parameters On Time To Normalization Of The Capillary Refill Time In Adult Patients With Septic Shock
NCT06122909
COMPLETED
PHASE3
Plasmalyte Versus Saline in Trauma Patients
NCT03630224
TERMINATED
PHASE3
Crystalloid Versus Hydroxyethyl Starch Trials
NCT00935168
COMPLETED
PHASE3
LUCAS Chest Compressor Versus Manual Chest Compression in Out-of-hospital Sudden Cardiac Arrest. LUCAT Trial
NCT01521208
UNKNOWN
PHASE3
Efficacy of 5% Albumin v/s Plasmalyte in Combination With 20% Albumin for Fluid Resuscitation in Cirrhosis With Sepsis Induced Hypotension
NCT06076330
UNKNOWN
NA
Extension of the RUSH Protocol for Volume Responsiveness
NCT03285269
WITHDRAWN
Neuromuscular Blockade for Post-Cardiac Arrest Care
NCT02260258
COMPLETED
PHASE2
Impact of Intravenous Lidocaine on Clinical Outcomes of Patients With ARDS During COVID-19 Pandemia
NCT04609865
TERMINATED
PHASE3
Strong Albumin Solutions in Patients With Septic Shock
NCT05208242
COMPLETED
PHASE2/PHASE3
Bicarbonate in Patients With Out-of-hospital Cardiac Arrest
NCT02303548
COMPLETED
PHASE2
Targeted Perfusion Based Haemodynamic Management in Critically Ill Patients Using Urethral Perfusion
NCT06158555
RECRUITING
NA
Naloxone for Opioid Associated Out of Hospital Cardiac Arrest
NCT06251609
NOT_YET_RECRUITING
PHASE2
Low Dose Vasopressin in Traumatic Shock
NCT00420407
TERMINATED
EARLY_PHASE1
Double Blind Randomized Trial of Saline vs Pentaspan for Resuscitation After Cardiac Surgery
NCT00337805
COMPLETED
PHASE2/PHASE3
Fluid Resuscitation With Hydroxyethyl Starch 130/0.4 in Trauma Patients
NCT03486600
UNKNOWN
NA
Surviving PEA in Roanoke (SPEAR) Study
NCT05283850
RECRUITING
PHASE2/PHASE3
"Effects of Neuromuscular Blocking Agents on End Expiratory Lung Volume During Moderate-severe ARDS"
NCT04996394
COMPLETED
Vexus-guided Fluid Management in Patients With Septic Shock After the Resuscitation Phase
NCT06227702
NOT_YET_RECRUITING
NA
Restricted or Liberal Fluid for Haemodynamic Resuscitation in Sepsis
NCT05453565
NOT_YET_RECRUITING
Endothelial Dysfunction in Resuscitated Cardiac Arrest
NCT02685618
COMPLETED
PHASE2
Impact of Amount of Fluid for Circulatory Resuscitation on Renal Function in Patients in Shock
NCT02666404
TERMINATED
NA
Impact of Tissue Plasminogen Activator (tPA) Treatment for an Atypical Acute Respiratory Distress Syndrome (COVID-19)
NCT04453371
WITHDRAWN
PHASE3
Cell Therapy Using Umbilical Cord-derived Mesenchymal Stromal Cells in SARS-CoV-2-related ARDS
NCT04333368
COMPLETED
PHASE1/PHASE2