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ID
Source
Brief title
Health condition
cardiac arrest, therapeutic hypothermia, neuromuscular blockade, train-of-four, pancuroniumbromide
Sponsors and support
Intervention
Outcome measures
Primary outcome
Median during untill TOF ratio 0.9 after 24 hours of pancuroniumbromide infusion.
Secondary outcome
N/A
Background summary
After cardiopulmonary resuscitation (CPR) is a nowadays common to treat survivors with therapeutic hypothermia for 24-48h. A lot of intensive care units use pancuroniumbromide as muscle relaxants during this therapeutic hypothermia. From normothermic patients we know there is a large interindividual variance in duration of action. After CPR and during hypothermia even more factors can be associated with a prolonged action of pancuroniumbromide. Therefore we want to conduct this observational trial, to measure the duration of action of pancuroniumbromide when given for 24h during therapeutic hypothermia after CPR.
Study objective
How long is the (median) duration from discontinuation of pancuronium after approximately 24h infusion until neuromuscular recovery to a TOF 0.9 in patients treated with therapeutic hypothermia after cardiac arrest?
Study design
Time of injection pancuronium (time 0);
Injection pancuronium – TOF ratio 0.7;
Injection pancuronium – TOF ratio 0.9;
Injection pancuronium – TOF ratio 1.0;
TOF ratio at planned discontinuation of sedation.
Intervention
Pancuroniumbromide infusion during 24 hours.
P. Debyelaan 25
L.P.W. Mommers
Maastricht 6229 HX
The Netherlands
+31 (0)43 3876385
l.mommers@mumc.nl
P. Debyelaan 25
L.P.W. Mommers
Maastricht 6229 HX
The Netherlands
+31 (0)43 3876385
l.mommers@mumc.nl
Inclusion criteria
Patient criteria:
1. Age > 18 years.
Cooling criteria:
1. Witnessed cardiac arrest;
2. Initial cardiac rhythm being VF/VT;
3. Delay from arrest till start CPR >5min, <15min;
4. Time from arrest till return of spontaneous circulation (ROSC) <60min;
5. Start cooling within 6 hours after ROSC.
Exclusion criteria
Exclusion from cooling (MUMC based):
1. Cardiac shock >30min after ROSC;
2. Coma before cardiac arrest;
3. Other cause of coma (CVA, trauma, intoxication);
4. Hypothermia on arrival at emergency department (<30 degrees Celsius);
5. Verbal reaction after ROSC;
6. Pregnancy;
7. Persistent hypoxia (SpO2<85%) >15min after ROSC;
8. Terminal disease state;
9. Pre-existing coagulation disorders (trombolysis is no contra-indication);
10. Persistent ventricular arrhythmias.
Exclusion because of study criteria:
1. Age < 18 years;
2. Contraindications for use of pancuronium;
3. No option for neuromuscular monitoring on at least one hand;
4. Use of confounding medication (anticonvulsants, steroid therapy, verapamil or aminoglycosides);
5. Renal failure;
6. Liver failure;
7. Neuromuscular diseases;
8. Use of other neuromuscular relaxants than pancuronium.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL2968 |
| NTR-old | NTR3115 |
| Other | : |
| ISRCTN | ISRCTN wordt niet meer aangevraagd. |