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Transitions Between Circulatory States After Out-of-Hospital Cardiac Arrest: Protocol for an Observational, Prospective Cohort Study.

Transitions Between Circulatory States After Out-of-Hospital Cardiac Arrest: Protocol for an Observational, Prospective Cohort Study.
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Langeland H, Bergum D, Løberg M, Bjørnstad K, Damås JK, Mollnes TE, Skjærvold NK, Klepstad P,


Langeland H, Bergum D, Løberg M, Bjørnstad K, Damås JK, Mollnes TE, Skjærvold NK, Klepstad P, (click to view)

Langeland H, Bergum D, Løberg M, Bjørnstad K, Damås JK, Mollnes TE, Skjærvold NK, Klepstad P,

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JMIR research protocols 2018 01 197(1) e17 doi 10.2196/resprot.8558
Abstract
BACKGROUND
The post cardiac arrest syndrome (PCAS) is responsible for the majority of in-hospital deaths following cardiac arrest (CA). The major elements of PCAS are anoxic brain injury and circulatory failure.

OBJECTIVE
This study aimed to investigate the clinical characteristics of circulatory failure and inflammatory responses after out-of-hospital cardiac arrest (OHCA) and to identify patterns of circulatory and inflammatory responses, which may predict circulatory deterioration in PCAS.

METHODS
This study is a single-center cohort study of 50 patients who receive intensive care after OHCA. The patients are followed for 5 days where detailed information from circulatory variables, including measurements by pulmonary artery catheters (PACs), is obtained in high resolution. Blood samples for inflammatory and endothelial biomarkers are taken at inclusion and thereafter daily. Every 10 min, the patients will be assessed and categorized in one of three circulatory categories. These categories are based on mean arterial pressure; heart rate; serum lactate concentrations; superior vena cava oxygen saturation; and need for fluid, vasoactive medications, and other interventions. We will analyze predictors of circulatory failure and their relation to inflammatory biomarkers.

RESULTS
Patient inclusion started in January 2016.

CONCLUSIONS
This study will obtain advanced hemodynamic data with high resolution during the acute phase of PCAS and will analyze the details in circulatory state transitions related to circulatory failure. We aim to identify early predictors of circulatory deterioration and favorable outcome after CA.

TRIAL REGISTRATION
ClinicalTrials.gov: NCT02648061; https://clinicaltrials.gov/ct2/show/NCT02648061 (Archived by WebCite at http://www.webcitation.org/6wVASuOla).

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