Transitions Between Circulatory States After Out-of-Hospital Cardiac Arrest: Protocol for an Observational, Prospective Cohort Study

Halvor Langeland; Daniel Bergum; Magnus Løberg; Knut Bjørnstad; Jan Kristian Damås; Tom Eirik Mollnes; Nils-Kristian Skjærvold; Pål Klepstad

doi:10.2196/resprot.8558

Transitions Between Circulatory States After Out-of-Hospital Cardiac Arrest: Protocol for an Observational, Prospective Cohort Study

JMIR Res Protoc. 2018 Jan 19;7(1):e17. doi: 10.2196/resprot.8558.

Authors

Halvor Langeland^#^{1

2}, Daniel Bergum^#^{1

3}, Magnus Løberg^#^{4

5}, Knut Bjørnstad^#⁶, Jan Kristian Damås^#^{3

7

8}, Tom Eirik Mollnes^#^{7

9

10

11}, Nils-Kristian Skjærvold^#^{1

2}, Pål Klepstad^#^{1

2}

Affiliations

¹ Department of Anesthesiology and Intensive Care Medicine, St. Olav's University Hospital, Trondheim, Norway.
² Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, The Norwegian University of Science and Technology, Trondheim, Norway.
³ Mid-Norway Sepsis Research Center, Norwegian University of Science and Technology, Trondheim, Norway.
⁴ Institute of Health and Society, Department of Health Management and Health Economics, Faculty of Medicine, University of Oslo, Oslo, Norway.
⁵ KG Jebsen Center for Colorectal Cancer Research, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
⁶ Clinic of Cardiology, St. Olav's University Hospital, Trondheim, Norway.
⁷ Centre of Molecular Inflammation Research, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
⁸ Department of Infectious Diseases, St. Olav's University Hospital, Trondheim, Norway.
⁹ KG Jebsen Inflammation Research Center, Department of Immunology, Oslo University Hospital, Oslo, Norway.
¹⁰ Research Laboratory, Nordland Hospital, Bodø, Norway.
¹¹ KG Jebsen Thrombosis Research and Expertise Center, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.

^# Contributed equally.

Abstract

Background: The post cardiac arrest syndrome (PCAS) is responsible for the majority of in-hospital deaths following cardiac arrest (CA). The major elements of PCAS are anoxic brain injury and circulatory failure.

Objective: This study aimed to investigate the clinical characteristics of circulatory failure and inflammatory responses after out-of-hospital cardiac arrest (OHCA) and to identify patterns of circulatory and inflammatory responses, which may predict circulatory deterioration in PCAS.

Methods: This study is a single-center cohort study of 50 patients who receive intensive care after OHCA. The patients are followed for 5 days where detailed information from circulatory variables, including measurements by pulmonary artery catheters (PACs), is obtained in high resolution. Blood samples for inflammatory and endothelial biomarkers are taken at inclusion and thereafter daily. Every 10 min, the patients will be assessed and categorized in one of three circulatory categories. These categories are based on mean arterial pressure; heart rate; serum lactate concentrations; superior vena cava oxygen saturation; and need for fluid, vasoactive medications, and other interventions. We will analyze predictors of circulatory failure and their relation to inflammatory biomarkers.

Results: Patient inclusion started in January 2016.

Conclusions: This study will obtain advanced hemodynamic data with high resolution during the acute phase of PCAS and will analyze the details in circulatory state transitions related to circulatory failure. We aim to identify early predictors of circulatory deterioration and favorable outcome after CA.

Trial registration: ClinicalTrials.gov: NCT02648061; https://clinicaltrials.gov/ct2/show/NCT02648061 (Archived by WebCite at http://www.webcitation.org/6wVASuOla).

Keywords: biomarkers; critical care; hemodynamics; inflammation; out-of-hospital cardiac arrest.

©Halvor Langeland, Daniel Bergum, Magnus Løberg, Knut Bjørnstad, Jan Kristian Damås, Tom Eirik Mollnes, Nils-Kristian Skjærvold, Pål Klepstad. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 19.01.2018.

Associated data

ClinicalTrials.gov/NCT02648061