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| ID | Type | Description | Link |
|---|---|---|---|
| 08/11457 | Other Identifier | SHDir | |
| 20708/2/IB | Other Identifier | NSD |
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| Name | Class |
|---|---|
| Norwegian Air Ambulance Foundation | OTHER |
| Norwegian University of Science and Technology | OTHER |
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The purpose of this study is to analyse transitions in cardiac rhythm and hemodynamic variables during resuscitation of patients with in-hospital cardiac arrest.
In-hospital cardiac arrest carries a grave prognosis, with survival to discharge in the range of 15-20%. Key factors determining outcome include the presenting cardiac rhythm, aetiology, and early initiation of resuscitation. Some cardiac rhythms benefit from defibrillation (shockable rhythms). During resuscitation patients may switch between shockable and non-shockable rhythms, and may show signs of spontaneous circulation temporarily. Depending on rhythm and according to guidelines, patients receive direct current (DC) shocks (defibrillator) and/or i.v. adrenaline, atropine and amiodarone, which may affect state-transitions. We wish to make statistical analysis (time-series analysis, Markov modelling) of these state-transitions and variations in hemodynamic variables during resuscitation, related to CPR interventions and the cause of arrest. The cause of arrest will be determined based on chart records, interview with staff and autopsy if appropriate. One hypothesis is that differences in the patterns of state-transitions may reflect underlying aetiology, which may guide in future decision-making during resuscitation.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cardiopulmonary resuscitation (CPR) | Procedure | CPR is performed according to international and national guidelines on all patients. |
| |
| Epinephrine | Drug | According to guidelines epinephrine 1 mg i.v. is administered every 3 minutes during cardiopulmonary resuscitation. |
| |
| Atropine | Drug | According to CPR guidelines atropine 3 mg i.v. is administered if asystole og PEA with frequency < 60 beat/min. | ||
| Amiodarone | Drug | According to guidelines amiodarone 300 mg i.v. is administered if recurrent ventricular fibrillation/tachycardia (VF/VT) during CPR. |
| |
| External defibrillator | Device | According to CPR guidelines patients with shockable rhythms may receive DC shocks. The defibrillator also stores physiological information regarding cardiac rhythm, pulse-oximetry, and end-tidal carbon dioxide (CO2) from endotracheal tube. |
| Measure | Description | Time Frame |
|---|---|---|
| Survival to discharge | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Short-term survival | minutes-days |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with in-hospital cardiac arrest at St.Olavs Hospital (Trondheim, Norway) during the study period.
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| Name | Affiliation | Role |
|---|---|---|
| Eirik Skogvoll, MD, PhD | St. Olavs Hospital | Study Chair |
| Trond Nordseth, MD | St. Olavs Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St.Olavs Hospital, Department of Anesthesia | Trondheim | 7014 | Norway |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29621571 | Result | Skjeflo GW, Nordseth T, Loennechen JP, Bergum D, Skogvoll E. ECG changes during resuscitation of patients with initial pulseless electrical activity are associated with return of spontaneous circulation. Resuscitation. 2018 Jun;127:31-36. doi: 10.1016/j.resuscitation.2018.03.039. Epub 2018 Apr 3. | |
| 23603153 | Derived |
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| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| D016757 | Death, Sudden, Cardiac |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D003645 | Death, Sudden |
| D003643 | Death |
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| ID | Term |
|---|---|
| D016887 | Cardiopulmonary Resuscitation |
| D004837 | Epinephrine |
| D001285 | Atropine |
| D000638 | Amiodarone |
| D047548 | Defibrillators |
| ID | Term |
|---|---|
| D012151 | Resuscitation |
| D004638 | Emergency Treatment |
| D013812 | Therapeutics |
| D004983 | Ethanolamines |
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|
| Nordseth T, Bergum D, Edelson DP, Olasveengen TM, Eftestol T, Wiseth R, Abella BS, Skogvoll E. Clinical state transitions during advanced life support (ALS) in in-hospital cardiac arrest. Resuscitation. 2013 Sep;84(9):1238-44. doi: 10.1016/j.resuscitation.2013.04.010. Epub 2013 Apr 19. |
| D010335 |
| Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D000605 |
| Amino Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D000588 | Amines |
| D015306 | Biogenic Monoamines |
| D001679 | Biogenic Amines |
| D002395 | Catecholamines |
| D002396 | Catechols |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D001286 | Atropine Derivatives |
| D014326 | Tropanes |
| D053961 | Azabicyclo Compounds |
| D001372 | Aza Compounds |
| D001533 | Belladonna Alkaloids |
| D012991 | Solanaceous Alkaloids |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D019086 | Bridged Bicyclo Compounds, Heterocyclic |
| D006572 | Heterocyclic Compounds, Bridged-Ring |
| D001572 | Benzofurans |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D004566 | Electrodes |
| D055615 | Electrical Equipment and Supplies |
| D004864 | Equipment and Supplies |