NEUROprotection Via optimizINg Cerebral Blood Flow afTer cArdiaC arresT (NEURO-INTACT) Study

National University Health System (NUHS)

Status: Enrolling

Conditions: Out-Of-Hospital Cardiac Arrest (OHCA)

Treatments: Other: Individualized blood pressure strategy

Study type: Interventional

Funder types: Other

Identifiers

NCT05679739

NEURO-INTACT

Details and patient eligibility

About

This single-center proof of concept study aims to assess the efficacy of a blood pressure strategy targeting person- and time-specific cerebral blood flow compared with standard-of-care using neuron-specific enolase as a quantitative biomarker of brain injury. Our central hypothesis is that an individualized blood pressure strategy targeting cerebral perfusion will reduce the extent of brain injury as indicated by changes in levels of neuron-specific enolase from baseline at 72 hours. To test this hypothesis, we will recruit 49 patients to an individualized blood pressure management strategy targeting cerebral blood flow, where optimal blood pressure will be serially calculated by the ICM+ brain monitoring software (Cambridge, UK) using inputs from transcranial Doppler ultrasound and near-infrared spectroscopy.

Enrollment: 49 estimated patients

Sex: All

Ages: 21 to 79 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. At least 21 years of age
2. Comatose defined as not being able to obey verbal commands and no verbal response to pain after sustained ROSC.

Exclusion criteria

1. ≥ 80 years old at time of enrolment
2. Pregnant patients
3. Limitations of care or life support therapy withdrawn within 24 hours of admission

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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49 participants in 1 patient group

Individualized blood pressure strategy

Experimental group

Description:

Hemodynamic optimization performed to an individualized target mean arterial pressure in the first 72 hours post ROSC based on cerebral perfusion assessed serially.

Treatment:

Other: Individualized blood pressure strategy