Early Neurological ASsessment with pupillometrY during Cardiac Arrest REsuscitation (EASY-CARE): protocol for an observational multicentre prospective study

Introduction Out-of-hospital cardiac arrest is burdened with a high rate of ineffective resuscitation and poor neurological outcome among survivors. To date, there are few perfusion assessment tools during cardiopulmonary resuscitation and none of them provide reliable data. Despite the lack of info...

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Main Authors: Frank Rasulo, Nicola Latronico, Simone Maria Zerbi, Claudio Sandroni, Marco Botteri, Antonio Bellasi
Format: Article
Language:English
Published: BMJ Publishing Group 2022-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/12/e063633.full
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author Frank Rasulo
Nicola Latronico
Simone Maria Zerbi
Claudio Sandroni
Marco Botteri
Antonio Bellasi
author_facet Frank Rasulo
Nicola Latronico
Simone Maria Zerbi
Claudio Sandroni
Marco Botteri
Antonio Bellasi
author_sort Frank Rasulo
collection DOAJ
description Introduction Out-of-hospital cardiac arrest is burdened with a high rate of ineffective resuscitation and poor neurological outcome among survivors. To date, there are few perfusion assessment tools during cardiopulmonary resuscitation and none of them provide reliable data. Despite the lack of information, physicians must decide whether to extend or terminate resuscitation efforts.Method and analysis This is a multicentre prospective, observational cohort study, involving adult patients, victims of unexpected out-of-hospital cardiac arrest. Early Neurological ASsessment with pupillometrY during Cardiac Arrest Resuscitation aims to primarily describe the reliability of quantitative pupillometry through use of the Neurological Pupillary Index (NPi) during the manoeuvre of cardiopulmonary resuscitation, as a predictor of the return of spontaneous circulation. The second objective is to seek and describe the association between the NPi and neurological outcome in the surviving cohort. Patients will be excluded if they are less than 18 years of age, have sustained traumatic brain injury, cerebrovascular emergencies, direct injury to the eyes or have pupil anomalies. Neurological outcome will be collected at intensive care unit discharge, at 30 days, 6 months and at 1 year. The Glasgow Coma Scale (GCS) will be used in the emergency department; modified Rankin Score will be adopted for neurological assessment; biomarkers and neurophysiology exams will be collected as well.Ethics and dissemination The study has been approved by Ethics Committee of Milano. Local committee acceptance is required for each of the centres involved in the clinical and follow-up data collection. Data will be disseminated to the scientific community through original articles submitted to peer-reviewed journals and abstracts to conferences.Trial registration number NCT05192772.
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spelling doaj-art-b0083b274a6d41e8b4fb05ff409902182025-08-20T03:11:20ZengBMJ Publishing GroupBMJ Open2044-60552022-12-01121210.1136/bmjopen-2022-063633Early Neurological ASsessment with pupillometrY during Cardiac Arrest REsuscitation (EASY-CARE): protocol for an observational multicentre prospective studyFrank Rasulo0Nicola Latronico1Simone Maria Zerbi2Claudio Sandroni3Marco Botteri4Antonio Bellasi5Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili;Department of Medical and Surgical Specialties, Radiological Sciences and Public Health,University of Brescia, Brescia, ItalyDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, ItalyEmergenza Rianimazione Anestesia, Azienda Socio Sanitaria Territoriale Lariana, Como, ItalyDepartment of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, ItalyAzienda Regionale Emergenza Urgenza, Milano, ItalyEnte Ospedaliero Cantonale, Lugano, Lugano, SwitzerlandIntroduction Out-of-hospital cardiac arrest is burdened with a high rate of ineffective resuscitation and poor neurological outcome among survivors. To date, there are few perfusion assessment tools during cardiopulmonary resuscitation and none of them provide reliable data. Despite the lack of information, physicians must decide whether to extend or terminate resuscitation efforts.Method and analysis This is a multicentre prospective, observational cohort study, involving adult patients, victims of unexpected out-of-hospital cardiac arrest. Early Neurological ASsessment with pupillometrY during Cardiac Arrest Resuscitation aims to primarily describe the reliability of quantitative pupillometry through use of the Neurological Pupillary Index (NPi) during the manoeuvre of cardiopulmonary resuscitation, as a predictor of the return of spontaneous circulation. The second objective is to seek and describe the association between the NPi and neurological outcome in the surviving cohort. Patients will be excluded if they are less than 18 years of age, have sustained traumatic brain injury, cerebrovascular emergencies, direct injury to the eyes or have pupil anomalies. Neurological outcome will be collected at intensive care unit discharge, at 30 days, 6 months and at 1 year. The Glasgow Coma Scale (GCS) will be used in the emergency department; modified Rankin Score will be adopted for neurological assessment; biomarkers and neurophysiology exams will be collected as well.Ethics and dissemination The study has been approved by Ethics Committee of Milano. Local committee acceptance is required for each of the centres involved in the clinical and follow-up data collection. Data will be disseminated to the scientific community through original articles submitted to peer-reviewed journals and abstracts to conferences.Trial registration number NCT05192772.https://bmjopen.bmj.com/content/12/12/e063633.full
spellingShingle Frank Rasulo
Nicola Latronico
Simone Maria Zerbi
Claudio Sandroni
Marco Botteri
Antonio Bellasi
Early Neurological ASsessment with pupillometrY during Cardiac Arrest REsuscitation (EASY-CARE): protocol for an observational multicentre prospective study
BMJ Open
title Early Neurological ASsessment with pupillometrY during Cardiac Arrest REsuscitation (EASY-CARE): protocol for an observational multicentre prospective study
title_full Early Neurological ASsessment with pupillometrY during Cardiac Arrest REsuscitation (EASY-CARE): protocol for an observational multicentre prospective study
title_fullStr Early Neurological ASsessment with pupillometrY during Cardiac Arrest REsuscitation (EASY-CARE): protocol for an observational multicentre prospective study
title_full_unstemmed Early Neurological ASsessment with pupillometrY during Cardiac Arrest REsuscitation (EASY-CARE): protocol for an observational multicentre prospective study
title_short Early Neurological ASsessment with pupillometrY during Cardiac Arrest REsuscitation (EASY-CARE): protocol for an observational multicentre prospective study
title_sort early neurological assessment with pupillometry during cardiac arrest resuscitation easy care protocol for an observational multicentre prospective study
url https://bmjopen.bmj.com/content/12/12/e063633.full
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