NCT04000334

Early Transcranial Doppler Goal Directed Therapy After Cardiac Arrest: a Pilot Study

• Status: Terminated
• Phase: N/A
• Study type: Interventional
• Enrollment: 20 (actual)
• Sponsor: Centre Hospitalier le Mans · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

Hypoxic-ischaemic brain injury (HIBI) is the main cause of death in patients who are comatose after resuscitation from cardiac arrest. Current guidelines recommend to target a mean arterial pressure (MAP) above 65 mmHg to achieve an adequate organ perfusion. Moreover, after cardiac arrest, cerebral autoregulation is dysregulated and cerebral blood flow (CBF) depends on the MAP. A higher blood pressure target could improve cerebral perfusion and HIBI. Transcranial Doppler (TCD) is a non-invasive method to study CBF and its variations induced by MAP. The aim of this study is to test the feasibility of an early-goal directed hemodynamic management with TCD during the first 12 hours after return of spontaneous circulation (ROSC).

Conditions

• Cardiac Arrest
• Cerebral Lesion
• Ischemic Encephalopathy
• Ischemic Reperfusion Injury

Interventions

Type	Name	Description
OTHER	MAP increased to optimize cerebral blood flow	MAP will be increased to 90-100 mmHg with norepinephrine. If TCD is still abnormal with a MAP of 90-100 mmHg, MAP will be increased to 100-110 mmHg. At each step, all CBF determinants will be recorded as well as cardiac output and Veinous jugular oxygen saturation (SvjO2). When TCD is normalized with no complications, MAP will be maintained at 90-100 or 100-110 mmHg during 24 hours.
OTHER	MAP between 65 and 85 mmHg	MAP will be maintained between 65-85 mmHg, using a norepinephrine infusion as needed.

Timeline

• Start date: 2020-07-29
• Primary completion: 2023-07-08
• Completion: 2023-07-08
• First posted: 2019-06-27
• Last updated: 2025-05-02

Locations

1 site across 1 country: France