Clinical Trial: Special Imaging Technique to Aid in the Diagnosis of Patients in Coma After Cardiac Arrest

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: CT Perfusion in the Prognostication of Patients in Coma Following Cardiac Arrest- A Pilot Study

Brief Summary: In the present pilot study, the investigators propose to determine if performing CT perfusion scans in post-cardiac arrest patients in coma will help prognosticate the outcome in these patients.

Detailed Summary:

Cardiac arrest is common and is associated with poor survival despite intensive medical care. These patients are subjected to cooling therapy to improve neurological outcomes. After cooling these patients are allowed to spontaneously return to normal body temperature. From here on, the outcome of these patients is mainly dependent on a wait and watch approach as the clinical examination of patients in a coma is very limited. Despite these attempts, 41% of these patients die and only 55 % of them have a favourable neurological outcome.

There have been few clinical scoring systems to provide prognosis in the face of a cardiac arrest but none of them address the more serious group- those in coma. For patients in coma, their medications, particularly those that suppress the central nervous system, cause difficulty in their clinical assessment. Multiple ancillary tests, such as routine CT or MRI of brain, do not give any useful prognostic information. We hypothesize that the neurological outcome of patients in coma is mainly dependent on presence of brainstem function.

To the best of our knowledge, no study has addressed the issue of brainstem function in cardiac arrest patients. This may be due to the fact that there was no imaging tool which could confidently depict the function of the brainstem. In a recently performed study in our institution, using CT perfusion technique, we have demonstrated that patients with diffusely impaired brainstem perfusion have poor prognosis and do not survive. This study is already being considered by the World Health Organization for the modification of criteria for the declaration of brain death. We suggest that a similar imaging technique will potentially be useful in prognosticating patients in coma following cardiac arrest.

In the present p
Sponsor: Nova Scotia Health Authority

Current Primary Outcome: Clinical evaluation of brainstem function [ Time Frame: 1 year ]

Original Primary Outcome: Same as current

Current Secondary Outcome: Number of adverse events as a measure of safety and tolerability [ Time Frame: 30 days ]

Original Secondary Outcome: Same as current

Information By: Nova Scotia Health Authority

Dates:
Date Received: March 28, 2014
Date Started: May 2014
Date Completion: December 2016
Last Updated: April 21, 2016
Last Verified: April 2016