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?
ID
Bron
Verkorte titel
Aandoening
cardiac arrest, therapeutic hypothermia, neuromuscular blockade, train-of-four, pancuroniumbromide
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Median during untill TOF ratio 0.9 after 24 hours of pancuroniumbromide infusion.
Achtergrond van het onderzoek
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.
Doel van het onderzoek
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?
Onderzoeksopzet
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.
Onderzoeksproduct en/of interventie
Pancuroniumbromide infusion during 24 hours.
Publiek
P. Debyelaan 25
L.P.W. Mommers
Maastricht 6229 HX
The Netherlands
+31 (0)43 3876385
l.mommers@mumc.nl
Wetenschappelijk
P. Debyelaan 25
L.P.W. Mommers
Maastricht 6229 HX
The Netherlands
+31 (0)43 3876385
l.mommers@mumc.nl
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
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.
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
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.
Opzet
Deelname
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