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Cerebral Oximetry After Cardiac Arrest (COACA)

心脏骤停后脑血氧饱和度测定 (COACA)

基本信息

批准号：
248706046
负责人：
Dr. Jens Witsch
金额：
--
依托单位：
The Neurological Institute Columbia - Presbyterian Medical Center College of Physicians & Surgeons of (aufgelöst)
依托单位国家：
德国
项目类别：
Research Fellowships
财政年份：
2013
资助国家：
德国
起止时间：
2012-12-31 至 2015-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/248706046?language=en
关键词：
Cerebral Oximetry After Cardiac Arrest

项目摘要

Clinical outcome after sudden cardiac arrest is very unfavorable with mortality rates of more than 90% and permanent brain damage in more than 50% of survivors The critical endpoint of cardio pulmonary resuscitation (CPR) is to prevent death and morbidity by establishing and maintaining brain perfusion and oxygenation; however, there is currently no simple and reliable way to evaluate the adequacy of brain tissue perfusion in cardiac arrest patients.The goal of the phase II study Cerebral Oximetry after Cardiac Arrest (COACA) is to develop and validate non-invasive brain tissue oxygen saturation (SbtO2) as a simple and effective measure of brain perfusion and oxygenation during and after resuscitation from cardiac arrest. We hypothesize that SbtO2 monitoring may one day be routinely used to (1) evaluate the adequacy of chest compressions, (2) avoid brain tissue hypoxia induced by excessive hyperventilation or shivering, (3) serve as an endpoint for goal-directed hemodynamic (blood pressure) support, and (4) evaluate the potential for neurological recovery. In cardiac arrest patients admitted to Columbia University Medical Center measurement of cerebral oxygenation (SbtO2) will be performed using near-infrared-spectroscopy (EQUANOX rSO2 technology brain oximeter, applied to via adhesive leads to the temples bilaterally) during and 48 hours after CPR (or until death). Apart from other parameters in the acute phase (blood pressure, arterial oxygen saturation, end tidal CO2 and cardiac output), neurological outcome will be measured until 90 days after hospital admission.Successful completion of the research will hopefully establish that SbtO2 monitoring is feasible during and after CPR and is a valid predictor of neurological recovery. If confirmed, it is anticipated that SbtO2 monitors may one day be routinely incorporated into portable cardiac defibrillators. Thresholds for optimal SbtO2 will be established, and future multicenter studies will be designed to determine whether goal-directed post-resuscitation hemodynamic support targeted at maintaining optimal SbtO2 values in the ICU can improve neurological outcome.

心脏骤停后的临床结果非常不利，死亡率超过90%，并且在超过50%的幸存者中存在永久性脑损伤。心肺复苏（CPR）的关键终点是通过建立和维持脑灌注和氧合来防止死亡和发病;但是，在此情况下，目前还没有简单可靠的方法来评估心脏骤停患者脑组织灌注的充分性。COACA）的目的是开发和验证无创脑组织氧饱和度（SbtO 2）作为心脏骤停复苏期间和复苏后脑灌注和氧合的简单有效测量方法。我们假设SbtO 2监测可能有一天会被常规用于（1）评估胸外按压的充分性，（2）避免过度换气或颤抖引起的脑组织缺氧，（3）作为目标导向的血流动力学（血压）支持的终点，（4）评估神经恢复的可能性。对于入住哥伦比亚大学医学中心的心脏骤停患者，将在CPR期间和CPR后48小时（或直至死亡）使用近红外光谱法（EQUANOX rSO 2技术脑血氧计，通过粘合剂导线应用于双侧太阳穴）测量脑氧合（SbtO 2）。除了急性期的其他参数（血压、动脉血氧饱和度、潮气末CO2和心输出量）外，还将测量神经功能结局，直至入院后90天。该研究的成功完成将有望确立SbtO 2监测在CPR期间和之后是可行的，并且是神经功能恢复的有效预测因素。如果得到证实，预计SbtO 2监测仪有一天会被常规地纳入便携式心脏起搏器。将建立最佳SbtO 2的标准，未来的多中心研究将设计用于确定目标导向的复苏后血流动力学支持是否可以改善ICU中的最佳SbtO 2值。