Defibrillation in Accidental Hypothermia

NCT ID: NCT06131892

Last Updated: 2023-11-18

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 63 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2023-04-01
• Study Completion Date: 2023-09-30

Brief Summary

Hypothermia (core temperature ≤35°C) is a frequent and life-threatening complication after mountain accidents, near-drowning, and intoxications, and can provoke arrhythmia, reduced cardiac contractility, and cardiac arrest. The hypothermic heart may be insensitive to defibrillation with a core temperature <30°C. Also, below <30°C after successful defibrillation, a perfusing rhythm often degenerates to ventricular fibrillation (VF) again. Repeated defibrillation can induce myocardial injury. Thus, the guidelines of the European Resuscitation Council (ERC) suggest delaying further defibrillation attempts until the core temperature is >30°C if VF persists after 3 shocks. Epinephrine should be withheld if core temperature is <30°C. Advanced Life Support (ALS) guidelines of the American Heart Association (AHA) state that it may be reasonable to perform further defibrillation attempts according to the standard algorithm and to consider administration of a vasopressor during cardiac arrest (Table 1). This discrepancy between ERC and AHA guidelines can be explained by the different interpretations of mainly animal data, which show that vasopressors increase the chances of successful defibrillation <30°C, defined as return of spontaneous circulation (ROSC) for at least 30 seconds. The guidelines of the Wilderness and Environmental Medicine Society (WMS) state that a single shock at a maximum power can be given for patients with a temperature <30°C.

The aim of this study is to evaluate clinical course of hypothermic patients(<30°C) undergoing defibrillation. The primary aim is to evaluate the success ratio of defibrillation, defined as ROSC for at least 30 seconds. Secondary aims are the recurrence rate of ventricular fibrillation, the number of defibrillation attempts per patient, the presence of cardiac dysfunction after defibrillation and the cerebral performance category (CPC) score at the end of hospitalization.

Conditions

Hypothermia, Accidental; Defibrillation

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: RETROSPECTIVE

Study Groups

Successful defibrillation during extra corporeal life support (ECLS) rewarming

Defibrillation

Intervention Type: OTHER

Defibrillation

Non Successful defibrillation during extra corporeal life support (ECLS) rewarming

Defibrillation

Intervention Type: OTHER

Defibrillation

Successful defibrillation before rewarming or during non-ECLS rewarming

non- ECLS: non- extra corporeal life support

Defibrillation

Intervention Type: OTHER

Defibrillation

Non- successful defibrillation before rewarming or during non-ECLS rewarming

non- ECLS: non- extra corporeal life support

Defibrillation

Intervention Type: OTHER

Defibrillation

Interventions

Defibrillation

Defibrillation

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• patients of the International Hypothermia Registry with a defibrillation while having a body core temperature equal or less than 30°C

Exclusion Criteria

• patients of the International Hypothermia Registry with a body core temperature >30°C
• patients who refused to participate

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University Hospital, Geneva

OTHER

Sponsor Role: lead

Responsible Party

Evelien Cools

Medical Doctor, Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Division of Anaesthesiology

Geneva, , Switzerland

Countries

Switzerland

Other Identifiers

2023-01087

Identifier Type: -

Identifier Source: org_study_id