Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
ID06048796

Early Cessation of Sedation and Targeted Temperature Management in Patients With a Favorable EEG After Cardiac Arrest: A Feasibility and Safety Study

Led by Medisch Spectrum Twente · Updated on 2024-05-13

40

Participants Needed

2

Research Sites

N/A

Total Duration

On this page

Sponsors

M

Medisch Spectrum Twente

Lead Sponsor

R

Rijnstate Hospital

Collaborating Sponsor

AI-Summary

What this Trial Is About

Researchers are evaluating the feasibility and safety of early weaning from intensive care treatment in adult patients who have experienced cardiac arrest and show a favorable EEG pattern within the first 12 hours. This favorable EEG indicates no or mild brain injury after the arrest. The study aims to determine if early stopping of sedation and targeted temperature management (TTM) benefits this subgroup compared to standard care. The study uses a cluster randomized crossover design with two groups. One group receives early cessation of sedation and TTM, followed by weaning from mechanical ventilation if appropriate. The other group receives standard care with sedation and TTM continued for at least 24 to 48 hours. The study will include about forty patients admitted to the ICU with postanoxic encephalopathy and an early favorable EEG. Participants will be monitored during their ICU stay, with researchers measuring the total time on mechanical ventilation, length of ICU stay, sedation duration, and any need to restart sedation or re-intubate. Neurological outcomes, cognitive function, complications, serious adverse events, and mortality will be assessed up to six months after the cardiac arrest. The entire ICU admission period, up to 30 days, will be observed for these outcomes to evaluate safety and feasibility.

CONDITIONS

Brief Title

Early Cessation of Sedation and TTM in Patients With a Favourable EEG After Cardiac Arrest

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Patients after cardiac arrest admitted to the ICU for treatment with sedation, targeted temperature management, and mechanical ventilation.
  • Age 18 years or older.
  • Continuous EEG measurement started within 12 hours after cardiac arrest.
  • Favorable EEG pattern within 12 hours after arrest, defined as a continuous background pattern.
  • Possibility to stop sedative treatment within three hours after identification of a favorable EEG pattern.
  • Written informed consent (deferred).
Not Eligible

You will not qualify if you...

  • Known history of another medical condition with limited life expectancy (less than 6 months).
  • Any progressive brain illness, such as a brain tumor or neurodegenerative disease.
  • Pre-admission Glasgow Outcome Scale Extended score of 4 or lower.
  • Reason other than neurological condition to continue sedation and/or ventilation.
  • Follow-up impossible due to logistic reasons.

AI-Screening

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Your Study Journey

Screening

Duration - Up to 12 hours after cardiac arrest

Participants are screened for eligibility to participate in the trial.

1 screening and enrollment visit (in-person in ICU)

Treatment

Duration - Up to 30 days or until ICU discharge

Participants receive either early cessation of sedation and targeted temperature management (TTM) with subsequent weaning from mechanical ventilation if appropriate, or standard care including sedation and TTM for at least 24-48 hours.

Continuous ICU monitoring during treatment period

Follow-up

Duration - Up to 6 months

Participants are monitored for safety and neurological outcomes after ICU discharge.

Assessments at 3 and 6 months post-treatment

Trial Site Locations

Total: 2 locations

1

Rijnstate hospital

Arnhem, Gelderland, Netherlands, 6815AD

Actively Recruiting

2

Medisch Spectrum Twente

Enschede, Overijssel, Netherlands, 7500KA

Actively Recruiting

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Research Team

M

Marleen C. Tjepkema-Cloostermans, PhD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NON_RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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