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Research on Key Technologies and System Optimization of Early Warning and Resuscitation of Cardiac Arrest

Primary Purpose

Emergencies

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Aortic balloon assisted resuscitation
Traditional cardiopulmonary resuscitation
Esophageal cooling
traditional cooling
Sponsored by
Second Affiliated Hospital, School of Medicine, Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Emergencies focused on measuring 5G, Aortic Balloon Occlusion Catheter, Esophageal cooling device, Cardiopulmonary resuscitation

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

18-75 years old Provide advanced life support Meet ethical requirements and sign informed consent return to spontaneous circulation coma

Exclusion Criteria:

Refusal of cardiopulmonary resuscitation Indications of non-resuscitation in the presence of traumatic cardiac arrest Patients with terminal malignant tumors or other diseases Cardiac arrest time>10min Cardiopulmonary resuscitation time>60min Hemodynamics need to be maintained by large doses of vasoactive drugs (adrenaline or norepinephrine dosage>1μg/kg.min) On the verge of Death status Patients with advanced malignant tumors or other end-stage diseases

Sites / Locations

  • Second Affiliated Hospital, Zhejiang University School of Medicine & Institute of Emergency Medicine, Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Active Comparator

Experimental

Active Comparator

Arm Label

Aortic balloon Assisted resuscitation group

Traditional cardiopulmonary resuscitation group

Esophageal cooling group

Traditional cooling group

Arm Description

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.

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.

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.

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.

Outcomes

Primary Outcome Measures

return of spontaneous circulation (ROSC)
ROSC can be identified with the following three conditions: 1. arterial pulse can be reached; 2. effective ECG rhythm; 3. systolic blood pressure > 60 mmHg (1 mm Hg = 0.133 kPa).

Secondary Outcome Measures

Full Information

First Posted
June 20, 2021
Last Updated
June 28, 2021
Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT04955288
Brief Title
Research on Key Technologies and System Optimization of Early Warning and Resuscitation of Cardiac Arrest
Official Title
Research on Key Technologies and System Optimization of Early Warning and Resuscitation of Cardiac Arrest
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Recruiting
Study Start Date
January 1, 2021 (Actual)
Primary Completion Date
December 30, 2023 (Anticipated)
Study Completion Date
November 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Studies have shown that early prevention and warning of cardiac arrest, rapid implementation of high-quality cardiopulmonary resuscitation, and strengthening of organ function protection after resuscitation are the keys to reducing the occurrence of cardiac arrest and improving the prognosis of patients. However, there are still many problems in the field of cardiopulmonary resuscitation in my country: 1) lack of effective prevention and early self-rescue system for cardiac arrest; 2) traditional resuscitation techniques implemented in pre-hospital and emergency rooms and poor results; 3) organs after resuscitation Insufficient protection means and effects. In our early stage, focusing on the above key issues, the study found that 5G technology can help high-risk emergency events including early warning, early detection and first aid of cardiac arrest. Aortic balloon occlusion can significantly improve the effectiveness of cardiopulmonary resuscitation. Transesophageal and CRRT cooling Can significantly optimize the organ protection intensity of therapeutic hypothermia. On the basis of the preliminary work, this project will carry out the research and development and clinical application of a series of new technologies for cardiac arrest warning and resuscitation, and work hard to help with cardiac arrest. Early warning and treatment of cases provide a set of optimized diagnosis and treatment technical solutions, which has important scientific, clinical and social significance.
Detailed Description
During the period from January 2022 to December 2023, based on the early warning and emergency response system of cardiac arrest, real-time monitoring of the vital information of the recruited high-risk populations of cardiac arrest, and timely reporting of the above-mentioned populations with unstable vital signs Distribute early warning information, contact community doctors to provide medical assistance, 120 emergency centers for referrals, and hospitals to prepare for admission, etc., in order to reduce the occurrence of cardiac arrest in high-risk groups; ②January 2022-December 2023 During the period, when a cardiac arrest event occurred in the recruited population based on the above-mentioned system, the nearby social volunteers, community doctors, and 120 emergency centers were quickly activated. Rescue team members quickly went to rescue, and at the same time realized experts' real-time observation and guidance of on-site treatment scenes through the remote consultation system, and prepared for continuous treatment in the hospital, in order to improve the effect of resuscitation and treatment of cardiac arrest in high-risk populations; ③analyze the above Within 2 years of application of the system, the incidence of cardiac arrest and the outcome of early resuscitation and treatment in the recruited high-risk population. 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. 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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Emergencies
Keywords
5G, Aortic Balloon Occlusion Catheter, Esophageal cooling device, Cardiopulmonary resuscitation

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
1000 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Aortic balloon Assisted resuscitation group
Arm Type
Experimental
Arm Description
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.
Arm Title
Traditional cardiopulmonary resuscitation group
Arm Type
Active Comparator
Arm Description
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.
Arm Title
Esophageal cooling group
Arm Type
Experimental
Arm Description
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.
Arm Title
Traditional cooling group
Arm Type
Active Comparator
Arm Description
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.
Intervention Type
Procedure
Intervention Name(s)
Aortic balloon assisted resuscitation
Intervention Description
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.
Intervention Type
Procedure
Intervention Name(s)
Traditional cardiopulmonary resuscitation
Intervention Description
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.
Intervention Type
Procedure
Intervention Name(s)
Esophageal cooling
Intervention Description
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.
Intervention Type
Procedure
Intervention Name(s)
traditional cooling
Intervention Description
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.
Primary Outcome Measure Information:
Title
return of spontaneous circulation (ROSC)
Description
ROSC can be identified with the following three conditions: 1. arterial pulse can be reached; 2. effective ECG rhythm; 3. systolic blood pressure > 60 mmHg (1 mm Hg = 0.133 kPa).
Time Frame
1-3 hours
Other Pre-specified Outcome Measures:
Title
survival to discharge
Description
whether patients survive to hospital discharge
Time Frame
2 days
Title
survival to discharge without severe neurological impairment
Description
defined as a CPC score of 1~2, which denotes survival with no more than moderate neurological disability with the ability to walk without assistance.
Time Frame
2 days
Title
1-month survival without severe neurological impairment
Description
patients who have survived for 1 month after cardiac arrest with a CPC score of 1~2
Time Frame
1 months
Title
6-month survival without severe neurological impairment
Description
patients who have survived for 6 months after cardiac arrest with a CPC score of 1~2
Time Frame
6 months
Title
insertion-related complications
Description
Whether esophageal mucosal injury,aortic injury,or some other complications occur in patients
Time Frame
2 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18-75 years old Provide advanced life support Meet ethical requirements and sign informed consent return to spontaneous circulation coma Exclusion Criteria: Refusal of cardiopulmonary resuscitation Indications of non-resuscitation in the presence of traumatic cardiac arrest Patients with terminal malignant tumors or other diseases Cardiac arrest time>10min Cardiopulmonary resuscitation time>60min Hemodynamics need to be maintained by large doses of vasoactive drugs (adrenaline or norepinephrine dosage>1μg/kg.min) On the verge of Death status Patients with advanced malignant tumors or other end-stage diseases
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mao Zhang, PHD
Phone
86-571-87784654
Email
z2jzk@zju.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mao Zhang, PHD
Organizational Affiliation
Second Affiliated Hospital of Zhejiang University School of Medicine
Official's Role
Study Chair
Facility Information:
Facility Name
Second Affiliated Hospital, Zhejiang University School of Medicine & Institute of Emergency Medicine, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310009
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mao Zhang, MD
Phone
86-571-87784654
Email
z2jzk@zju.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No
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Research on Key Technologies and System Optimization of Early Warning and Resuscitation of Cardiac Arrest

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