Neuroprotection Bundles For Comatose Survivors Following Cardiac Arrest

A Multicenter, Prospective, Stepped Wedge Cluster Randomized Controlled Study on the Effect of Neuroprotection Bundles on the Improvement of Neurological Outcomes After Cardiopulmonary Resuscitation

The investigators designed LAPTOPS to determine the effectiveness of a goal-directed neuroprotection bundles of active management including body temperature,PaCO2,PaO2,position,Blood glucose ,blood sodium,Blood pressure and Lactate vs. usual care in adult post-cardiac arrest care.

LAPTOPS is a large-scale pragmatic clinical trial to provide reliable evidence over the effectiveness of a widely applicable goal-directed care bundle in acute phase of adult post-cardiac arrest care.

Inclusion Criteria:

• Age ≥ 18 years and < 80 years
• Patients of in-hospital or out-of-hospital cardiac arrest who have returned -spontaneous circulation (ROSC) after cardiopulmonary resuscitation and do not require CPR for more than 20 minutes;
• Patients who are unconscious after ROSC, defined as FOUR motor response score < 4 points or GSC ≤ 8 points;
• Family members or legal representatives signed informed consent.

Exclusion Criteria:

• Unwitnessed cardiac arrest, estimated time from cardiac arrest to start of CPR > 30 minutes;
• Time from cardiac arrest to ROSC > 60 minutes;
• Patients who woke up immediately after ROSC by CPR;
• End-stage diseases;
• Cardiac arrest considered to be caused by neurological diseases;
• The patient was in a vegetative state before cardiac arrest;
• The interval from the onset of cardiac arrest to enrollment is >72 hours .