Reoxygenation After Cardiac Arrest (REOX Study)



Status:Recruiting
Conditions:Cardiology
Therapuetic Areas:Cardiology / Vascular Diseases
Healthy:No
Age Range:18 - Any
Updated:4/21/2016
Start Date:June 2013
End Date:June 2017
Contact:Stephen Trzeciak, MD, MPH
Email:trzeciak-stephen@cooperhealth.edu
Phone:856-342-3342

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The broad objective of this study is to test the association between hyperoxia exposure
after resuscitation from cardiac arrest and outcome. Our overarching hypothesis is that
hyperoxia after ROSC is associated with increased oxidative stress and worsened neurological
and cognitive outcomes.

Specific Aim 1: Test if the degree and duration of hyperoxia following ROSC from cardiac
arrest is associated with the degree of in vivo oxidative stress during the
post-resuscitation phase of therapy.

Approach: We will conduct a multicenter prospective observational study of adult patients
resuscitated from cardiac arrest. We will record data pertaining to oxygenation parameters
and other factors and measure biomarkers of oxidative stress (isoprostanes and isofurans) in
the plasma at 0 and 6 hours after ROSC using gas chromatography negative ion chemical
ionization mass spectrometry. We will determine the exposure to post-ROSC hyperoxia by
calculating the time-weighted average PaO2 and SaO2 for the post-resuscitation phase of
therapy, and will test the association with plasma isoprostane and isofuran levels.

Specific Aim 2: Test if the degree and duration of hyperoxia following ROSC from cardiac
arrest is associated with the degree of neurological disability at hospital discharge.

Approach: In the study described above, we will determine the Modified Rankin Scale at
hospital discharge. We will perform multivariable analyses adjusted for numerous covariates
known to be associated with outcome in post-cardiac arrest patients to determine if
post-ROSC hyperoxia exposure is independently associated with neurological disability.

Specific Aim 3: Test if the degree and duration of hyperoxia following ROSC from cardiac
arrest is associated with neuropsychological outcomes among survivors at 180 days.

Approach: In the study described above, we will assess neuropsychological outcome among
survivors at 180 days. Neuropsychological testing will use validated instruments across five
cognitive domains (attention, Wechsler Adult Intelligence Scale-IV-digit span; (2)
reasoning, Wechsler Adult Intelligence Scale-IV-similarities; (3) immediate and delayed
memory, Wechsler Memory Scale-III-logical memory I and II; (4) verbal fluency, Controlled
Oral Word Association Test; and (5) executive functioning, Hayling Sentence Completion
Test). We will perform multivariable analyses to determine if post-ROSC hyperoxia exposure
is independently associated with neuropsychological deficits.

Inclusion Criteria:

- Age >17 years

- Cardiac arrest

- Return of spontaneous circulation

- Not following commands immediately after ROSC

- Endotracheal intubation

- Clinician intent to treat with therapeutic hypothermia (or absence of clinician
intent to withhold therapeutic hypothermia)

Exclusion Criteria:

- Presumed etiology of arrest is trauma

- Presumed etiology of arrest is hemorrhage

- Presumed etiology of arrest is sepsis

- Permanent resident of nursing home or other long-term care facility

- Any other condition, that in the opinion of the investigator, would preclude the
subject from being a suitable candidate, e.g. end stage chronic illness with no
reasonable expectation of survival to hospital discharge
We found this trial at
5
sites
330 Brookline Ave
Boston, Massachusetts 02215
617-667-7000
Principal Investigator: Nathan I Shapiro, MD, MPH
Beth Israel Deaconess Medical Center Beth Israel Deaconess Medical Center (BIDMC) is one of the...
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Boston, MA
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2500 N State St
Jackson, Mississippi 39216
(601) 984-1000
Principal Investigator: Alan E Jones, MD
University of Mississippi Medical Center The University of Mississippi Medical Center, located in Jackson, is...
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Jackson, MS
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1 Cooper Plaza
Camden, New Jersey 08103
(856) 342-2000
Principal Investigator: J. Hope Kilgannon, MD
Cooper University Hospital Cooper University Health Care, the clinical campus of Cooper Medical School of...
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Camden, NJ
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Indianapolis, Indiana 46202
Principal Investigator: Jeffrey A Kline, MD
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Indianapolis, IN
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Philadelphia, Pennsylvania 19104
Principal Investigator: Benjamin S Abella, MD, MPhil
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Philadelphia, PA
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