Our general objective, during this study, is to evaluate the feasibility and potential physiological benefits of using REBOA (resuscitative endovascular balloon occlusion of the aorta) CPR (cardiopulmonary resuscitation) for patients presenting with a cardiac arrest to a community hospital. This would represent the first step for doing a larger, randomized clinical trial on the use of REBOA in non-traumatic cardiac arrest.
Primary objective: Validate the feasibility of using REBOA in a community hospital setting during cardiac arrest as an adjunct to ACLS (advances cardiac life support) . This will be done by measuring time to REBOA placement and successful inflation. Furthermore, we will also document any REBOA related complications. Secondary objectives: Evaluate the potential physiological benefits of REBOA for human subjects in NTCA (non traumatic cardiac arrest) that are not responding to standard ACLS. Study Design and Methodology Trial design The trial is a single-center, single-arm, open (unblinded), feasibility, experimental study. Study Duration The study is expected to begin in winter 2022 and last approximately 12 months. Population studied The population studied will be patients in non-traumatic cardiac arrest at Santa Cabrini Hospital, aged 18-75 years old. Patients presenting with a witnessed cardiac arrest (out of hospital cardiac arrest (OHCA) or in hospital cardiac arrest (IHCA)) and in which ACLS was performed for at least 15 minutes or BLS for at least 30 minutes and for no more than 60 minutes will be evaluated for eligibility to participate in the study. Number of patients 20
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
balloon occlusion of the aorta during cardiac arrest to optimize coronary and cerebral perfusion.
success rate and time of REBOA inflation during non-traumatic arrest in a community hospital
● Feasibility of intra-arrest REBOA catheter placement and zone 1 inflation in NTCA in a community hospital setting
Time frame: 1 year
blood pressure
* Systolic blood pressure (Pre balloon occlusion, Post balloon occlusion 30sec, 1min, 5min, 10min, 15min) * Diastolic blood pressure (Pre balloon occlusion, Post balloon occlusion 30sec, 1min, 5min, 10min, 15min)
Time frame: 0-15 min per study over a year
ETCO2
(Pre balloon occlusion, Post balloon occlusion 30sec, 1min, 5min, 10min, 15min)
Time frame: 0-15 min per study over a year
cerebral saturation
(Pre balloon occlusion, Post balloon occlusion 30sec, 1min, 5min, 10min, 15min)
Time frame: 0-15 min per study over a year
ROSC
return of spontaneous circulation
Time frame: 0-30 min per study over a year
TEE-guided REBOA positioning
success rate of determining REBOA placement by trans esophageal echocardiography
Time frame: 5 minutes per study over 1 year
7 day survival
follow up to 7 days
Time frame: 7 days over a year
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