Evaluation of Muscle StO2 as a Prognostic Factor After Out of Hospital Cardiac Arrest

Overview

Out of hospital cardiac arrest is a major health problem. Prognosis is still poor even after return to spontaneous circulation. The pathophysiology of cardiac arrest implies ischemia-reperfusion and sepsis like syndrome. These phenomenons can lead to microvascular dysfunction explaining probably multi-organ failure after cardiac arrest. Few means allow the exploration of microvascular function in human. Muscle StO2 is a technique allowing the assessment of microvascular function non-invasively. The aim of this study is to evaluate muscle StO2 as a prognostic factor after out of hospital cardiac arrest.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Masking: None (Open Label)
  • Study Primary Completion Date: March 2013

Detailed Description

Out of hospital cardiac arrest is a major health problem accounting for 375000 deaths each year in Europe. Even after return to spontaneous circulation, survival is poor because of complications such as post-anoxic encephalopathy and multi-organ failure. The pathophysiology of cardiac arrest implies ischemia-reperfusion and sepsis like syndrome. These conditions are frequently associated with microvascular dysfunction that can be the "motor" of multi-organ failure. Few means allow the exploration of microvascular function in human. Recently, StO2, a non-invasive technique assessing microvascular function has been described. This technique measures the tissular saturation of a muscle using the near-infrared spectroscopy technique. It has been described to be a good prognostic factor during haemorrhagic shock state. Dynamic parameters such as reperfusion slope allow discriminating between survivors and survivors after severe sepsis. This dynamic test assesses the microvasculature recruitment that could be a marker of better prognosis. The aim of this study is to evaluate muscle StO2 as a prognostic factor after out of hospital cardiac arrest.

Interventions

  • Other: Vascular occlusion test
    • Reperfusion slope after vascular occlusion test

Clinical Trial Outcome Measures

Primary Measures

  • Reperfusion slope after vascular occlusion test. This parameter will be compared between survivors and non-survivors
    • Time Frame: Four measurements : on admission, since the body core temperature reaches 34°, after 24 hours of hypothermia and 48 hours after admission to ICU

Secondary Measures

  • Muscle StO2 during the first 2 days Lactatemia during the first 2 days These parameters will be compared between survivors and non-survivors
    • Time Frame: Muscle StO2 will be monitored continuously during the first 2 days Lactatemia will be measured every 12 hours until normalization

Participating in This Clinical Trial

Inclusion Criteria

  • Out of hospital cardiac arrest – Patient aged between 18 and 80 years – Having a Social Security System Exclusion Criteria:

  • Pregnant women, lack of appropriate consent

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 80 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Department of Clinical Research and Innovation
  • Collaborator
    • Centre Hospitalier Universitaire de Nice
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Department of Clinical Research and Innovation, Department of Clinical Research and innovation (drc) – Centre Hospitalier Universitaire de Nice
  • Overall Official(s)
    • Jean-Christophe ORBAN, MD, Principal Investigator, Centre Hospitalier Universitaire de Nice
  • Overall Contact(s)
    • Jean-Christophe ORBAN, MD, +33 4 92 03 33 00, orban.j@chu-nice.fr

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