Sedation, Temperature and Pressure After Cardiac Arrest and Resuscitation
Region Skane
3,500 participants
Aug 17, 2023
INTERVENTIONAL
Conditions
Summary
The STEPCARE-trial is a 2x2x2 randomised trial studying patients who have been resuscitated from cardiac arrest and who are comatose. It will include three different interventions focusing on sedation targets, temperature targets and mean arterial pressure targets.
Eligibility
Inclusion Criteria5
- Out-of-hospital cardiac arrest
- Sustained ROSC - defined as 20 minutes with signs of circulation without the need for chest compressions
- Unconsciousness defined as not being able to obey verbal commands (FOUR-score motor response of \<4) or being intubated and sedated because of agitation after sustained ROSC.
- Eligible for intensive care without restrictions or limitations
- Inclusion within 4 hours of ROSC
Exclusion Criteria5
- On ECMO prior to randomization
- Pregnancy
- Suspected or confirmed intracranial hemorrhage
- Previously randomized in the STEPCARE trial
- Trauma or hemorrhage being the presumed cause of arrest
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Interventions
If core body temperature exceeds 37.7°C a feedback controlled-device will be used and set at 37.5°C.
A MAP target of \>85mmHg will be used. Vasopressors will be titrated to this target during 36h.
Deep sedation for at least 36h
Management of fever in the ICU without a device
A MAP target of \>65mmHg will be used. Vasopressors will be titrated to this target during 36h.
A strategy of minimal sedation in the ICU, used only as needed to facilitate transport, imaging and invasive procedures.
Locations(56)
View Full Details on ClinicalTrials.gov
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NCT05564754