심인성 쇼크 및 심정지 후 환자에서 산염기 장애 및 환기 설정 평가: VentilO 알고리즘과의 비교 (VentilO CU)
심인성 쇼크 및 심정지 후 환자의 산염기 장애 및 환기 설정 평가: VentilO 알고리즘과의 비교
This study aims to better understand how mechanical ventilation settings affect patients admitted to the coronary care unit after cardiac arrest or with cardiogenic shock. These patients often require mechanical ventilation, but current guidelines provide limited evidence on the best approach. Improper ventilation settings can lead to acid-base imbalances, such as respiratory acidosis or alkalosis, which may worsen patient outcomes.
The retrospective analysis will include 100 adult patients (50 post-cardiac arrest and 50 with cardiogenic shock) who were mechanically ventilated upon admission. The study has two main objectives:
Determine how often acid-base disorders occur in these patients and describe their characteristics.
Compare the initial ventilator settings chosen by clinicians with those suggested by VentilO, a decision-support algorithm.
The investigators will evaluate the potential effect of the VentilO recommendations on the first arterial (or capillary) blood gases compared to the real settings.
This information will help refine the algorithm and guide future research on improving ventilation strategies for critically ill cardiac patients.
Participation does not involve any intervention, as the study uses existing medical records.
연구 개요
연구 유형
등록 (추정된)
연락처 및 위치
연구 연락처
- 이름: Francois Lellouche
- 전화번호: 3572 1-418-656-8711
- 이메일: francois.lellouche@criucpq.ulaval.ca
연구 장소
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Quebec
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Québec, Quebec, 캐나다, G1V4G5
- 모병
- Insitut universitaire de cardiologie et de pneumologie de Quebec - Universite Laval
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연락하다:
- Francois Lellouche Principal Investigator
- 전화번호: 3572 418-656-8711
- 이메일: francois.lellouche@criucpq.ulaval.ca
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참여기준
자격 기준
공부할 수 있는 나이
- 어린이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
샘플링 방법
연구 인구
post cardiac arrest or cardiogenic shock
설명
Inclusion Criteria:
- Adult (Age >=18 years old)
- Under mechanical ventilation with endotracheal tube for :
post cardiac arrest or cardiogenic shock
- Bood gases result availability up to 4 hours after coronary unit admission
Exclusion Criteria:
- Lack of patient anthropometric data (height and weight) available in the patient record
- No information in the record regarding the data on the humidification systems used at the time of the first blood gas test upon admission to the coronary care unit.
- Patient stabilzed in other hospital before coronary unit admission or adjustment of respiratory parameters after a blood gas test.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 관찰 모델: COHORT
- 시간 관점: RETROSPECTIVE
코호트 및 개입
그룹/코호트 |
개입 / 치료 |
|---|---|
|
심정지 후 환자
|
Blood gases evaluation after initiation of mechanical ventilation |
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심인성 쇼크 환자
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Blood gases evaluation after initiation of mechanical ventilation |
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Acid-base disorder (respiratory acidosis)
기간: Up to 4 hours after admission to the coronary care unit - First blood gas sample
|
Presence of respiratory acisosis define by pH< 7.35 and PaCO2 > 45 mmHg |
Up to 4 hours after admission to the coronary care unit - First blood gas sample
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Acid-base disorder (respiratory alcalosis)
기간: Up to 4 hours after admission to the coronary care unit - First blood gas sample
|
Presence of respiratory alcalosis define by by pH>7.45 and PaCO2 < 35 mmHg |
Up to 4 hours after admission to the coronary care unit - First blood gas sample
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Ventilator setting (Respiratory rate)
기간: Up to 4 hour after coronary unit admission - At the last ventilator setting before blood gas sample
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Respiratory rate set by the doctor, these setting will be compared to the suggestion of the algorithm |
Up to 4 hour after coronary unit admission - At the last ventilator setting before blood gas sample
|
|
Ventilator setting (Tidal volume)
기간: Up to 4 hour after coronary unit admission - At the last ventilator setting before blood gas sample
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Tidal volume set by the doctor, these setting will be compared to the suggestion of the algorithm |
Up to 4 hour after coronary unit admission - At the last ventilator setting before blood gas sample
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Acid-base disorder (metabolic acidosis)
기간: Up to 4 hours after admission to the coronary care unit - First blood gas sample
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Presence of metabolic acidosis define by HCO3 < 20 mmol/L |
Up to 4 hours after admission to the coronary care unit - First blood gas sample
|
|
Acid-base disorder (metabolic alcalosis)
기간: Up to 4 hours after admission to the coronary care unit - First blood gas sample
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Presence of metabolic acidosis define by HCO3 > 28 mmol/L |
Up to 4 hours after admission to the coronary care unit - First blood gas sample
|
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Optimal acid-base result
기간: Up to 4 hours after admission to the coronary care unit - First blood gas sample
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Presence of optimal pH (7.35-7.45) with optimal PCO2 (35-45 mmHg) |
Up to 4 hours after admission to the coronary care unit - First blood gas sample
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Mechanical ventilation duration
기간: Up to 90 days
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Time spent with invasive mechanical ventilation aftercoronary unit admission and hospital discharge |
Up to 90 days
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Vasopressor duration
기간: Day 28
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Duration of vasopressor or inotrop administration |
Day 28
|
|
Hospital length of stay
기간: Up to 90 days
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Coronary unit admission through hospital discharge |
Up to 90 days
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Mortality
기간: Day 28
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Mortality at coronary unit |
Day 28
|
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Acute renal failure
기간: Up to 90 days. Coronary unit stay - admission through discharge or until death if occured
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Rate of acute renal failure during coronary unit length of stay. Renal failure will be defined according to the usual criteria, i.e., an increase of >27 mmol/L creatinine in 48 hours or 1.5x over the baseline |
Up to 90 days. Coronary unit stay - admission through discharge or until death if occured
|
공동 작업자 및 조사자
스폰서
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
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