What this Trial Is About

Researchers are evaluating treatments for patients who have been resuscitated after an Out-of-Hospital Cardiac Arrest (OHCA) and suffer from Post Cardiac Arrest Syndrome, which involves systemic inflammation, brain and heart dysfunction, and the original cause of the arrest. This phase III trial aims to improve outcomes for unconscious OHCA patients by testing four different interventions that target inflammation, brain blood flow, sedation duration, and delirium prevention. The study hopes to reduce the high death rate mainly caused by brain injury in these patients. The trial randomly assigns about 1000 patients to receive one of four interventions: high-dose steroids (dexamethasone) or placebo to reduce inflammation; backrest elevation at 5 degrees or 35 degrees during sedation; early wakeup and potential extubation after 6 hours or standard timing at 28-36 hours; and prophylactic olanzapine or placebo to prevent delirium. Steroids and olanzapine are given in three doses. The backrest position is maintained for up to 72 hours or until extubation. Wakeup timing differs between groups and follows specific clinical criteria. Participants will be closely monitored in intensive care with regular checks of their backrest position, sedation levels, and heart rhythm for 96 hours. Researchers will measure mortality at 90 days for the steroid and backrest interventions, and days alive outside the hospital within 30 days for the wakeup and olanzapine interventions. The study includes detailed assessments of brain function, sedation, and delirium, aiming to gather comprehensive data on treatment safety and effectiveness over several months.

The Danish Out-of-Hospital Cardiac Arrest Study