Trial Outcomes & Findings for Reoxygenation After Cardiac Arrest II (REOX II Study) (NCT NCT02698826)

NCT ID: NCT02698826

Last Updated: 2022-03-29

Results Overview

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

16 participants

Primary outcome timeframe

Change in the isofurans/isoprostanes ratio between 0 and 6 hours post-ROSC

Results posted on

2022-03-29

Participant Flow

Participant milestones

Participant milestones
Measure
Adult Patients Resuscitated From Cardiac Arrest
Rapid FiO2 optimization protocol Protocol for rapid FiO2 optimization: We plan to test a protocol for FiO2 optimization for mechanically ventilated post-cardiac arrest subjects, with a therapeutic goal of partial pressure of arterial oxygen (PaO2) of 60-99 mmHg, based on the PaO2 range that was associated with the lowest risk of poor outcome in our previously published work. We also use PaO2 (measured by arterial blood gas \[ABG\] analysis) as the ultimate goal rather than arterial oxygen saturation (SaO2) measured by pulse oximetry because an SaO2 value \<100% on pulse oximetry monitoring does not always exclude supranormal PaO2. The protocol in this application begins with very rapid reduction of FiO2 as much as possible according to SaO2 values, and when FiO2 is maximally reduced by SaO2 an ABG is measured, followed by finer adjustment of FiO2 to achieve a PaO2 60-99 mmHg. The protocol not only prescribes each downward titration of FiO2 but it also includes detailed limbs for upward titration of FiO2 to account for potential "overshoot" in FiO2 reduction.
Overall Study
STARTED
16
Overall Study
COMPLETED
2
Overall Study
NOT COMPLETED
14

Reasons for withdrawal

Reasons for withdrawal
Measure
Adult Patients Resuscitated From Cardiac Arrest
Rapid FiO2 optimization protocol Protocol for rapid FiO2 optimization: We plan to test a protocol for FiO2 optimization for mechanically ventilated post-cardiac arrest subjects, with a therapeutic goal of partial pressure of arterial oxygen (PaO2) of 60-99 mmHg, based on the PaO2 range that was associated with the lowest risk of poor outcome in our previously published work. We also use PaO2 (measured by arterial blood gas \[ABG\] analysis) as the ultimate goal rather than arterial oxygen saturation (SaO2) measured by pulse oximetry because an SaO2 value \<100% on pulse oximetry monitoring does not always exclude supranormal PaO2. The protocol in this application begins with very rapid reduction of FiO2 as much as possible according to SaO2 values, and when FiO2 is maximally reduced by SaO2 an ABG is measured, followed by finer adjustment of FiO2 to achieve a PaO2 60-99 mmHg. The protocol not only prescribes each downward titration of FiO2 but it also includes detailed limbs for upward titration of FiO2 to account for potential "overshoot" in FiO2 reduction.
Overall Study
Death
13
Overall Study
Adverse Event
1

Baseline Characteristics

Reoxygenation After Cardiac Arrest II (REOX II Study)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
FiO2 Titration Group
n=16 Participants
Rapid FiO2 optimization protocol Protocol for rapid FiO2 optimization: We plan to test a protocol for FiO2 optimization for mechanically ventilated post-cardiac arrest subjects, with a therapeutic goal of partial pressure of arterial oxygen (PaO2) of 60-99 mmHg, based on the PaO2 range that was associated with the lowest risk of poor outcome in our previously published work. We also use PaO2 (measured by arterial blood gas \[ABG\] analysis) as the ultimate goal rather than arterial oxygen saturation (SaO2) measured by pulse oximetry because an SaO2 value \<100% on pulse oximetry monitoring does not always exclude supranormal PaO2. The protocol in this application begins with very rapid reduction of FiO2 as much as possible according to SaO2 values, and when FiO2 is maximally reduced by SaO2 an ABG is measured, followed by finer adjustment of FiO2 to achieve a PaO2 60-99 mmHg. The protocol not only prescribes each downward titration of FiO2 but it also includes detailed limbs for upward titration of FiO2 to account for potential "overshoot" in FiO2 reduction.
Age, Continuous
55 years
STANDARD_DEVIATION 18 • n=99 Participants
Sex: Female, Male
Female
7 Participants
n=99 Participants
Sex: Female, Male
Male
9 Participants
n=99 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=99 Participants
Race (NIH/OMB)
White
13 Participants
n=99 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
Region of Enrollment
United States
16 participants
n=99 Participants

PRIMARY outcome

Timeframe: Change in the isofurans/isoprostanes ratio between 0 and 6 hours post-ROSC

Population: Not analyzed secondary to no measurements obtained for intervention arm.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Upon hospital discharge, on average two weeks

0: No symptoms at all 1. No significant disability despite symptoms; able to carry out all usual duties and activities 2. Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance 3. Moderate disability; requiring some help, but able to walk without assistance 4. Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance 5. Severe disability; bedridden, incontinent and requiring constant nursing care and attention 6. Dead

Outcome measures

Outcome measures
Measure
FiO2 Titration
n=16 Participants
Not analyzed secondary to insufficient samples
Modified Rankin Scale (mRS) (Primary Neurological Outcome)
6 score on a scale
Interval 0.0 to 6.0

OTHER_PRE_SPECIFIED outcome

Timeframe: 180 days

Population: No analysis performed secondary to no patients were able to undergo the neuropsychological testing.

The neuropsychological testing uses validated instruments across five cognitive domains: (1) 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.

Outcome measures

Outcome data not reported

Adverse Events

FiO2 Titration

Serious events: 14 serious events
Other events: 0 other events
Deaths: 13 deaths

Serious adverse events

Serious adverse events
Measure
FiO2 Titration
n=16 participants at risk
Single arm
Cardiac disorders
Death
81.2%
13/16 • Number of events 13 • 1.5 years
Nervous system disorders
Poor neurological outcome
6.2%
1/16 • Number of events 1 • 1.5 years

Other adverse events

Adverse event data not reported

Additional Information

Brian Roberts, MD/ REOX Study Director

Cooper University Health Care

Phone: 856-342-2352

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place