Research on Key Technologies and System Optimization of Early Warning and Resuscitation of Cardiac Arrest
NCT ID: NCT04955288
Last Updated: 2021-07-08
Study Results
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Basic Information
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UNKNOWN
NA
1000 participants
INTERVENTIONAL
2021-01-01
2024-11-30
Brief Summary
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Detailed Description
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2. Selected patients with cardiac arrest in our hospital from January 2022 to December 2023. Selection criteria: a. 18-75 years old, no gender limit; b. Advanced life support; c. Meet ethical requirements and sign informed consent. Exclusion criteria: a. Refusal of cardiopulmonary resuscitation; b. Indications of non-resuscitation for traumatic cardiac arrest; c. Patients with terminal malignant tumors or other diseases. The patients undergoing cardiac arrest were randomly divided into the traditional cardiopulmonary resuscitation group and the aortic balloon-assisted resuscitation group. The former adopts the traditional chest compression mode, and the latter uses aortic balloon blockade on the basis of the traditional resuscitation mode. Technology, compare the resuscitation effects of patients with cardiac arrest in our hospital within 2 years, such as the duration of cardiopulmonary resuscitation, the amount of adrenaline, the number of defibrillation, the success rate of resuscitation, the survival rate of admission, etc., to clarify that aortic balloon occlusion can improve the effectiveness of cardiopulmonary resuscitation Significant role in.
3. Selected patients with cardiac arrest in our hospital from January 2022 to December 2023. Selection criteria: a. 18 to 75 years old, no gender limit; b. return to spontaneous circulation; c. coma; d. meet ethical requirements and sign informed consent. Exclusion criteria: a. Cardiac arrest time\> 10 min; b. Cardiopulmonary resuscitation time\> 60 min; c. Hemodynamics need to be maintained by high-dose vasoactive drugs (adrenaline or norepinephrine dosage\> 1μg/kg.min); d. The state of dying; e. Patients with advanced malignant tumors or other end-stage diseases. Cardiac arrest patients who had obtained spontaneous circulation were randomly divided into traditional cooling group and esophageal cooling group, respectively, as soon as possible after resuscitation, using body surface cooling blanket device and esophageal cooling device to implement sub-hypothermia, and compare the effect of low-temperature implementation in patients within 2 years, such as the start time, Target length, maintenance of low temperature, rewarming and other indicators, as well as clinical prognostic indicators such as multiple organ dysfunction, adverse events, ICU length of stay, total length of stay, immediate discharge and neurological prognosis and survival at 1, 3, and 6 months In order to clarify the strong protective effect of optimal implementation of therapeutic mild hypothermia through the esophagus on multiple organ damage after resuscitation.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
OTHER
NONE
Study Groups
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Aortic balloon Assisted resuscitation group
The aortic balloon-assisted resuscitation group uses aortic balloon occlusion technology on the basis of the traditional resuscitation mode, that is, when the cardiopulmonary resuscitation begins, the aortic balloon catheter is quickly punctured and inserted to the distal end of the aortic area I via ultrasound. (Septum level), then continue to inflate the balloon to block the aortic blood flow until the end of the cardiopulmonary resuscitation to deflate the balloon and remove the balloon catheter.
Aortic balloon assisted resuscitation
On the basis of the traditional resuscitation mode, the aortic balloon occlusion technology is used, that is, at the same time when the cardiopulmonary resuscitation starts, the aortic balloon catheter is quickly punctured to the distal end of the aortic zone I (septum level) through ultrasound assistance, and then Continue to inflate the balloon to block the aortic blood flow until the end of the cardiopulmonary resuscitation to deflate the balloon and remove the balloon catheter.
Traditional cardiopulmonary resuscitation group
The traditional cardiopulmonary resuscitation group uses the traditional manual chest compression mode, that is, referring to the latest version of the cardiopulmonary resuscitation guidelines, manual chest compressions are performed under the monitoring of the compression quality feedback device to ensure that the compression depth is 5-6cm, the frequency is 100-120 times/min, Conditions such as a fixed compression position and sufficient chest wall rebound.
Traditional cardiopulmonary resuscitation
Use the traditional manual chest compression mode, that is, refer to the latest version of the CPR Guidelines.
Artificial chest compressions are performed under the monitoring of the pressure quality feedback device to ensure that the compression depth is 5-6cm, the frequency is 100-120 times/min, the compression position is fixed, and the chest wall fully rebounds.
Esophageal cooling group
The esophageal cooling group adopts a new transesophageal cooling method, that is, an esophageal cooling catheter is placed after resuscitation in patients with cardiac arrest, and then a small temperature-controlled water circulation system is continuously perfused with 4℃ cold water. After the patient's body temperature reaches the target temperature of 33℃, the temperature is adjusted Control the water circulation system to maintain the target body temperature of (33±0.5)°C for 24 hours, and then reheat to (37±0.5)°C normal body temperature at a rate of 0.25-0.5°C/h and maintain it for 24 hours.
Esophageal cooling
The new transesophageal cooling method is adopted, that is, the esophageal cooling catheter is indwelled after resuscitation in patients with cardiac arrest, and then connected to a small temperature-controlled water circulation system to continuously infuse 4℃ cold water. After the patient's body temperature reaches the target temperature of 33℃, the temperature-controlled water circulation system is adjusted Maintain the target body temperature of (33±0.5)°C for 24 hours, and then rewarm to (37±0.5)°C normal body temperature at a rate of 0.25-0.5°C/h and maintain it for 24 hours.
Traditional cooling group
The traditional cooling group uses the traditional body surface ice blanket cooling method, that is, the patients with cardiac arrest lie on the temperature control blanket after resuscitation, and then use the ice blanket host to continuously infuse the temperature control blanket with 4℃ cold water, and wait until the patient's body temperature reaches the target temperature of 33℃ After that, adjust the ice blanket host to control the circulating water temperature to maintain the target body temperature of (33±0.5)°C for 24 hours, and then reheat to the normal body temperature of (37±0.5)°C at a rate of 0.25-0.5°C/h and maintain it for 24 hours.
traditional cooling
The traditional body surface ice blanket cooling method is adopted, that is, the patient with cardiac arrest lies on the temperature control blanket after resuscitation, and then uses the ice blanket host to continuously infuse the temperature control blanket with 4℃ cold water, and wait until the patient's body temperature reaches the target temperature of 33℃. The temperature of the circulating water is controlled by adjusting the ice blanket host to maintain the target body temperature of (33±0.5)°C for 24 hours, and then reheat to the normal body temperature of (37±0.5)°C at a rate of 0.25-0.5°C/h and maintain it for 24 hours.
Interventions
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Aortic balloon assisted resuscitation
On the basis of the traditional resuscitation mode, the aortic balloon occlusion technology is used, that is, at the same time when the cardiopulmonary resuscitation starts, the aortic balloon catheter is quickly punctured to the distal end of the aortic zone I (septum level) through ultrasound assistance, and then Continue to inflate the balloon to block the aortic blood flow until the end of the cardiopulmonary resuscitation to deflate the balloon and remove the balloon catheter.
Traditional cardiopulmonary resuscitation
Use the traditional manual chest compression mode, that is, refer to the latest version of the CPR Guidelines.
Artificial chest compressions are performed under the monitoring of the pressure quality feedback device to ensure that the compression depth is 5-6cm, the frequency is 100-120 times/min, the compression position is fixed, and the chest wall fully rebounds.
Esophageal cooling
The new transesophageal cooling method is adopted, that is, the esophageal cooling catheter is indwelled after resuscitation in patients with cardiac arrest, and then connected to a small temperature-controlled water circulation system to continuously infuse 4℃ cold water. After the patient's body temperature reaches the target temperature of 33℃, the temperature-controlled water circulation system is adjusted Maintain the target body temperature of (33±0.5)°C for 24 hours, and then rewarm to (37±0.5)°C normal body temperature at a rate of 0.25-0.5°C/h and maintain it for 24 hours.
traditional cooling
The traditional body surface ice blanket cooling method is adopted, that is, the patient with cardiac arrest lies on the temperature control blanket after resuscitation, and then uses the ice blanket host to continuously infuse the temperature control blanket with 4℃ cold water, and wait until the patient's body temperature reaches the target temperature of 33℃. The temperature of the circulating water is controlled by adjusting the ice blanket host to maintain the target body temperature of (33±0.5)°C for 24 hours, and then reheat to the normal body temperature of (37±0.5)°C at a rate of 0.25-0.5°C/h and maintain it for 24 hours.
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
18 Years
75 Years
ALL
No
Sponsors
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Second Affiliated Hospital, School of Medicine, Zhejiang University
OTHER
Responsible Party
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Principal Investigators
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Mao Zhang, PHD
Role: STUDY_CHAIR
Second Affiliated Hospital of Zhejiang University School of Medicine
Locations
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Second Affiliated Hospital, Zhejiang University School of Medicine & Institute of Emergency Medicine, Zhejiang University
Hangzhou, Zhejiang, China
Countries
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Central Contacts
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Facility Contacts
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References
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Other Identifiers
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2021-0420
Identifier Type: -
Identifier Source: org_study_id
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