Sedation, Temperature and Pressure After Cardiac Arrest and Resuscitation (STEPCARE)
Cardiac Arrest With Successful Resuscitation, Hypoxia, Brain
About this trial
This is an interventional treatment trial for Cardiac Arrest With Successful Resuscitation
Eligibility Criteria
Inclusion Criteria:
- Out-of-hospital cardiac arrest
- Sustained ROSC - defined as 20 minutes with signs of circulation without the need for chest compressions
- Unconsciousness defined as not being able to obey verbal commands (FOUR-score motor response of <4) or being intubated and sedated because of agitation after sustained ROSC.
- Eligible for intensive care without restrictions or limitations
- Inclusion within 4 hours of ROSC
Exclusion Criteria:
- Unwitnessed cardiac arrest with an initial rhythm of asystole
- On ECMO prior to randomization
- Pregnancy
- Suspected or confirmed intracranial hemorrhage
- Previously randomized in the STEPCARE trial.
Sites / Locations
- Nepean Hospital
- Liverpool Hospital
- John Hunter Hospital
- Concord Repatriation Hospital
- Royal North Shore Hospital
- St George Hospital
- The Sutherland Hospital
- Westmead Hospital
- Princess Alexandra Hospital
- The Prince Charles Hospital
- Northern Hospital
- Austin Hospital
- The Victorian Heart Hospital
- Helsinki Helsingforgs University Central HospitalRecruiting
- Kuopio University Hospital
- Centre Hospitalier de Luxembourg
- Wellington HospitalRecruiting
- Hallands hospitalRecruiting
- Helsingborg Hospital
- Skåne University HospitalRecruiting
- Skåne University Hospital MalmöRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Arm 8
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Sedation, temperature device and high MAP
Sedation, no temperature device and high MAP
Sedation, temperature device and low MAP
Sedation, no temperature device and low MAP
Minimal sedation, temperature device and high MAP
Minimal sedation, no temperature device and high MAP
Minimal sedation, temperature device and low MAP
Minimal sedation, no temperature device and low MAP
Continuous deep sedation for 36 hours Fever management with a feedback-controlled device if temperature above 37.7°C. A mean arterial pressure target of >85mmHg.
Continuous deep sedation for 36 hours. Fever management without a feedback-controlled device. A mean arterial pressure target of >85mmHg.
Continuous deep sedation for 36 hours. Fever management with a feedback-controlled device if temperature above 37.7°C. A mean arterial pressure target of >65mmHg.
Continuous deep sedation for 36 hours. Fever management without a feedback-controlled device. A mean arterial pressure target of >65mmHg.
Minimal sedation (and early extubation if possible). Fever management with a feedback-controlled device if temperature above 37.7°C. A mean arterial pressure target of >85mmHg.
Minimal sedation (and early extubation if possible). Fever management without a feedback-controlled device. A mean arterial pressure target of >65mmHg.
Minimal sedation (and early extubation if possible). Fever management with a feedback-controlled device if temperature above 37.7°C. A mean arterial pressure target of >65mmHg.
Minimal sedation (and early extubation if possible). Fever management without a feedback-controlled device. A mean arterial pressure target of >65mmHg.