Targeted Therapeutic Mild Hypercapnia After Resuscitated Cardiac Arrest

Summary

The TAME Cardiac Arrest trial will study the ability of higher arterial carbon dioxide (PaCO2) levels to reduce brain damage, comparing giving patients 'normal' to 'slightly higher than normal' blood PaCO2 levels and assessing their ability to return to normal life-tasks. It will be the largest trial ever conducted in heart attack patients in the intensive care unit. This therapy is cost free and, if shown to be effective, will improve thousands of lives, transform clinical practice, and yield major savings.

Conditions

• Out-Of-Hospital Cardiac Arrest

Interventions

OTHER

Targeted therapeutic mild hypercapnia

Patients allocated to the TTMH protocol will be sedated to achieve moderate to deep sedation (a target Richmond Agitation Scale Score of -4). Arterial blood gases and end- tidal carbon dioxide levels will be measured at baseline and then used to guide respiratory rate adjustments of minute ventilation to remain within the target PaCO2 range of 50-55 mmHg. Arterial blood gases will be repeated every 4 hours for 24 hours following randomisation or if end-tidal carbon dioxide values change \>5 mmHg

OTHER

Targeted normocapnia (Standard care)

Patients allocated to the standard care (TN) protocol will be managed according to current practice and in accordance with ILCOR guidelines which recommend maintaining normocapnia in these patients. They will be sedated to achieve moderate to deep sedation (a target Richmond Agitation Scale Score of - 4). Arterial blood gases and end-tidal carbon dioxide levels will be measured at baseline and then used to guide respiratory rate adjustments of minute ventilation to remain within the target PaCO2 range of 35-45 mmHg. Arterial blood gases will be repeated every 4 hours for 24 hours following randomisation or if end-tidal carbon dioxide values change \>5 mmHg.

Sponsors & Collaborators

• National Health and Medical Research Council, Australia

  collaborator OTHER

• Health Research Board, Ireland

  collaborator OTHER

• Australian and New Zealand Intensive Care Research Centre

  lead OTHER

Principal Investigators

• Glenn M Eastwood, RN, PhD · Monash University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-02-15

Primary Completion

2022-12-31

Completion

2022-12-31

Countries

• Australia
• Belgium
• Denmark
• Finland
• France
• Ireland
• Italy
• Netherlands
• New Zealand
• Norway
• Saudi Arabia
• Slovenia
• Sweden
• United Kingdom

Study Locations