Detail
Článek
Článek online
FT
Medvik - BMČ
  • Je něco špatně v tomto záznamu ?

Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial

P. Nordberg, FS. Taccone, A. Truhlar, S. Forsberg, J. Hollenberg, M. Jonsson, J. Cuny, P. Goldstein, N. Vermeersch, A. Higuet, FC. Jiménes, FR. Ortiz, J. Williams, D. Desruelles, J. Creteur, E. Dillenbeck, C. Busche, HJ. Busch, M. Ringh, D....

. 2019 ; 321 (17) : 1677-1685. [pub] 20190507

Jazyk angličtina Země Spojené státy americké

Typ dokumentu srovnávací studie, časopisecké články, multicentrická studie, randomizované kontrolované studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc19027626
E-zdroje Online Plný text

NLK Open Access Digital Library od 1998-01-01 do Před 6 měsíci
Medline Complete (EBSCOhost) od 1998-01-07 do Před 1 měsícem

Odkazy

PubMed 31063573
DOI 10.1001/jama.2019.4149
Knihovny.cz E-zdroje

Importance: Therapeutic hypothermia may increase survival with good neurologic outcome after cardiac arrest. Trans-nasal evaporative cooling is a method used to induce cooling, primarily of the brain, during cardiopulmonary resuscitation (ie, intra-arrest). Objective: To determine whether prehospital trans-nasal evaporative intra-arrest cooling improves survival with good neurologic outcome compared with cooling initiated after hospital arrival. Design, Setting, and Participants: The PRINCESS trial was an investigator-initiated, randomized, clinical, international multicenter study with blinded assessment of the outcome, performed by emergency medical services in 7 European countries from July 2010 to January 2018, with final follow-up on April 29, 2018. In total, 677 patients with bystander-witnessed out-of-hospital cardiac arrest were enrolled. Interventions: Patients were randomly assigned to receive trans-nasal evaporative intra-arrest cooling (n = 343) or standard care (n = 334). Patients admitted to the hospital in both groups received systemic therapeutic hypothermia at 32°C to 34°C for 24 hours. Main Outcomes and Measures: The primary outcome was survival with good neurologic outcome, defined as Cerebral Performance Category (CPC) 1-2, at 90 days. Secondary outcomes were survival at 90 days and time to reach core body temperature less than 34°C. Results: Among the 677 randomized patients (median age, 65 years; 172 [25%] women), 671 completed the trial. Median time to core temperature less than 34°C was 105 minutes in the intervention group vs 182 minutes in the control group (P < .001). The number of patients with CPC 1-2 at 90 days was 56 of 337 (16.6%) in the intervention cooling group vs 45 of 334 (13.5%) in the control group (difference, 3.1% [95% CI, -2.3% to 8.5%]; relative risk [RR], 1.23 [95% CI, 0.86-1.72]; P = .25). In the intervention group, 60 of 337 patients (17.8%) were alive at 90 days vs 52 of 334 (15.6%) in the control group (difference, 2.2% [95% CI, -3.4% to 7.9%]; RR, 1.14 [95% CI, 0.81-1.57]; P = .44). Minor nosebleed was the most common device-related adverse event, reported in 45 of 337 patients (13%) in the intervention group. The adverse event rate within 7 days was similar between groups. Conclusions and Relevance: Among patients with out-of-hospital cardiac arrest, trans-nasal evaporative intra-arrest cooling compared with usual care did not result in a statistically significant improvement in survival with good neurologic outcome at 90 days. Trial Registration: ClinicalTrials.gov Identifier: NCT01400373.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc19027626
003      
CZ-PrNML
005      
20190823120453.0
007      
ta
008      
190813s2019 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1001/jama.2019.4149 $2 doi
035    __
$a (PubMed)31063573
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Nordberg, Per $u Department of Medicine, Center for Resuscitation Science, Karolinska Institute, Solna, Sweden.
245    10
$a Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial / $c P. Nordberg, FS. Taccone, A. Truhlar, S. Forsberg, J. Hollenberg, M. Jonsson, J. Cuny, P. Goldstein, N. Vermeersch, A. Higuet, FC. Jiménes, FR. Ortiz, J. Williams, D. Desruelles, J. Creteur, E. Dillenbeck, C. Busche, HJ. Busch, M. Ringh, D. Konrad, J. Peterson, JL. Vincent, L. Svensson,
520    9_
$a Importance: Therapeutic hypothermia may increase survival with good neurologic outcome after cardiac arrest. Trans-nasal evaporative cooling is a method used to induce cooling, primarily of the brain, during cardiopulmonary resuscitation (ie, intra-arrest). Objective: To determine whether prehospital trans-nasal evaporative intra-arrest cooling improves survival with good neurologic outcome compared with cooling initiated after hospital arrival. Design, Setting, and Participants: The PRINCESS trial was an investigator-initiated, randomized, clinical, international multicenter study with blinded assessment of the outcome, performed by emergency medical services in 7 European countries from July 2010 to January 2018, with final follow-up on April 29, 2018. In total, 677 patients with bystander-witnessed out-of-hospital cardiac arrest were enrolled. Interventions: Patients were randomly assigned to receive trans-nasal evaporative intra-arrest cooling (n = 343) or standard care (n = 334). Patients admitted to the hospital in both groups received systemic therapeutic hypothermia at 32°C to 34°C for 24 hours. Main Outcomes and Measures: The primary outcome was survival with good neurologic outcome, defined as Cerebral Performance Category (CPC) 1-2, at 90 days. Secondary outcomes were survival at 90 days and time to reach core body temperature less than 34°C. Results: Among the 677 randomized patients (median age, 65 years; 172 [25%] women), 671 completed the trial. Median time to core temperature less than 34°C was 105 minutes in the intervention group vs 182 minutes in the control group (P < .001). The number of patients with CPC 1-2 at 90 days was 56 of 337 (16.6%) in the intervention cooling group vs 45 of 334 (13.5%) in the control group (difference, 3.1% [95% CI, -2.3% to 8.5%]; relative risk [RR], 1.23 [95% CI, 0.86-1.72]; P = .25). In the intervention group, 60 of 337 patients (17.8%) were alive at 90 days vs 52 of 334 (15.6%) in the control group (difference, 2.2% [95% CI, -3.4% to 7.9%]; RR, 1.14 [95% CI, 0.81-1.57]; P = .44). Minor nosebleed was the most common device-related adverse event, reported in 45 of 337 patients (13%) in the intervention group. The adverse event rate within 7 days was similar between groups. Conclusions and Relevance: Among patients with out-of-hospital cardiac arrest, trans-nasal evaporative intra-arrest cooling compared with usual care did not result in a statistically significant improvement in survival with good neurologic outcome at 90 days. Trial Registration: ClinicalTrials.gov Identifier: NCT01400373.
650    _2
$a senioři $7 D000368
650    _2
$a mozek $x patofyziologie $7 D001921
650    _2
$a poranění mozku $x etiologie $x prevence a kontrola $7 D001930
650    _2
$a kardiopulmonální resuscitace $x metody $7 D016887
650    12
$a urgentní zdravotnické služby $7 D004632
650    _2
$a epistaxe $x etiologie $7 D004844
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    _2
$a terapeutická hypotermie $x škodlivé účinky $x přístrojové vybavení $x metody $7 D007036
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a zástava srdce mimo nemocnici $x komplikace $x mortalita $x terapie $7 D058687
650    _2
$a velikost vzorku $7 D018401
650    _2
$a jednoduchá slepá metoda $7 D016037
650    _2
$a míra přežití $7 D015996
650    _2
$a čas zasáhnout při rozvinutí nemoci $7 D061665
650    _2
$a výsledek terapie $7 D016896
655    _2
$a srovnávací studie $7 D003160
655    _2
$a časopisecké články $7 D016428
655    _2
$a multicentrická studie $7 D016448
655    _2
$a randomizované kontrolované studie $7 D016449
655    _2
$a práce podpořená grantem $7 D013485
700    1_
$a Taccone, Fabio Silvio $u Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
700    1_
$a Truhlar, Anatolij $u Emergency Medical Services of the Hradec Kralove Region, Czech Republic.
700    1_
$a Forsberg, Sune $u Department of Medicine, Center for Resuscitation Science, Karolinska Institute, Solna, Sweden. Department of Anesthesiology and Intensive Care, Norrtälje Hospital, Norrtälje, Sweden.
700    1_
$a Hollenberg, Jacob $u Department of Medicine, Center for Resuscitation Science, Karolinska Institute, Solna, Sweden.
700    1_
$a Jonsson, Martin $u Department of Medicine, Center for Resuscitation Science, Karolinska Institute, Solna, Sweden.
700    1_
$a Cuny, Jerome $u Emergency Department and SAMU, Centre Hospitalier Régional Universitaire de Lille, Lille, France.
700    1_
$a Goldstein, Patrick $u Emergency Department and SAMU, Centre Hospitalier Régional Universitaire de Lille, Lille, France.
700    1_
$a Vermeersch, Nick $u Emergency Department, St Maria Hospital, Halle, Belgium.
700    1_
$a Higuet, Adeline $u Emergency Department, St Maria Hospital, Halle, Belgium.
700    1_
$a Jiménes, Francisco Carmona $u Sistema d'Emergències Mèdiques, Barcelona, Catalunya, Spain.
700    1_
$a Ortiz, Fernando Rosell $u Empresa Pública de Emergencias Sanitarias, Almería, Andalucía, Spain.
700    1_
$a Williams, Julia $u School of Health and Social Work, University of Hertfordshire, Hertfordshire, United Kingdom.
700    1_
$a Desruelles, Didier $u Emergency Department, University Hospitals of Leuven, Leuven, Belgium.
700    1_
$a Creteur, Jacques $u Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
700    1_
$a Dillenbeck, Emelie $u Department of Medicine, Center for Resuscitation Science, Karolinska Institute, Solna, Sweden.
700    1_
$a Busche, Caroline $u Department of Emergency Medicine, University Hospital of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
700    1_
$a Busch, Hans-Jörg $u Department of Emergency Medicine, University Hospital of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
700    1_
$a Ringh, Mattias $u Department of Medicine, Center for Resuscitation Science, Karolinska Institute, Solna, Sweden.
700    1_
$a Konrad, David $u Department of Physiology and Pharmacology, Karolinska Institute, and Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
700    1_
$a Peterson, Johan $u Department of Physiology and Pharmacology, Karolinska Institute, and Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
700    1_
$a Vincent, Jean-Louis $u Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
700    1_
$a Svensson, Leif $u Department of Medicine, Center for Resuscitation Science, Karolinska Institute, Solna, Sweden.
773    0_
$w MED00002973 $t JAMA $x 1538-3598 $g Roč. 321, č. 17 (2019), s. 1677-1685
856    41
$u https://pubmed.ncbi.nlm.nih.gov/31063573 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20190813 $b ABA008
991    __
$a 20190823120707 $b ABA008
999    __
$a ok $b bmc $g 1432775 $s 1066086
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2019 $b 321 $c 17 $d 1677-1685 $e 20190507 $i 1538-3598 $m JAMA (Chicago, Ill.) $n JAMA $x MED00002973
LZP    __
$a Pubmed-20190813

Najít záznam

Citační ukazatele

Možnosti archivace