An observational study in Hypothermia, Accidental and Defibrillation, sponsored by University Hospital, Geneva. Completed at 1 site in Switzerland. Per ClinicalTrials.gov, last updated 2023-11-18.
Sponsored by University Hospital, Geneva · Observational
Hypothermia (core temperature ≤35°C) is a frequent and life-threatening complication after mountain accidents, near-drowning, and intoxications, and can provoke arrhythmia, reduced cardiac contractility, and cardiac arrest. The hypothermic heart may be insensitive to defibrillation with a core temperature \<30°C. Also, below \<30°C after successful defibrillation, a perfusing rhythm often degenerates to ventricular fibrillation (VF) again. Repeated defibrillation can induce myocardial injury. Thus, the guidelines of the European Resuscitation Council (ERC) suggest delaying further defibrillation attempts until the core temperature is >30°C if VF persists after 3 shocks. Epinephrine should be withheld if core temperature is \<30°C. Advanced Life Support (ALS) guidelines of the American Heart Association (AHA) state that it may be reasonable to perform further defibrillation attempts according to the standard algorithm and to consider administration of a vasopressor during cardiac arrest (Table 1). This discrepancy between ERC and AHA guidelines can be explained by the different interpretations of mainly animal data, which show that vasopressors increase the chances of successful defibrillation \<30°C, defined as return of spontaneous circulation (ROSC) for at least 30 seconds. The guidelines of the Wilderness and Environmental Medicine Society (WMS) state that a single shock at a maximum power can be given for patients with a temperature \<30°C.
The aim of this study is to evaluate clinical course of hypothermic patients(\<30°C) undergoing defibrillation. The primary aim is to evaluate the success ratio of defibrillation, defined as ROSC for at least 30 seconds. Secondary aims are the recurrence rate of ventricular fibrillation, the number of defibrillation attempts per patient, the presence of cardiac dysfunction after defibrillation and the cerebral performance category (CPC) score at the end of hospitalization.
499 studies on the registry are indexed under Hypothermia; 53 are open to participants now.
This study's enrollment of 63 is below the median of 97 across 126 observational studies indexed under Hypothermia.
Browse Hypothermia studies →University Hospital, Geneva is the lead sponsor of 372 studies on the registry; 68 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Patients with accidental hypothermia and a body core temperature equal or less than 30°C who had one or more defibrillation attempts
Exclusion Criteria:
Other: Defibrillation
Other: Defibrillation
non- ECLS: non- extra corporeal life support
Other: Defibrillation
non- ECLS: non- extra corporeal life support
Other: Defibrillation
Defibrillation
the number of patients with a core temperature equal or less than 30°C who had a successful defibrillation, defined as ROSC for at least 30 seconds
Time frame: through study completion, an average of 3 months
the number of patients with a return to ventricular fibrillation after successful defibrillation
Time frame: through study completion, an average of 3 months
the rate of defibrillation attempts per patient
Time frame: through study completion, an average of 3 months
the number of patients with the presence of cardiac dysfunction after defibrillation
a decrease in cardiac output, or a reduced ejection fraction, systolic or diastolic dysfunction on echocardiographic ultrasound
Time frame: through study completion, an average of 3 months
cerebral performance category (CPC) score of every patient at the end of hospitalization
a score from 1 to 5, with "1" meaning "Good Outcome", "5" means dead
Time frame: through study completion, an average of 3 months
Plan to share: No
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This study is completed, as verified in Nov 2023. You cannot join it, but the record below documents what was studied.
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University Hospital, Geneva