Continuous jugular venous oxygen saturation monitoring after cardiac arrest

Feasibility and Validation of Continuous Measurement of Jugular Venous Oxygen Saturation in Comatose Patients After Cardiac Arrest

This project will test continuous and intermittent jugular venous oxygen saturation monitoring in adults who are comatose after cardiac arrest to see if brain oxygen delivery patterns can be detected and tracked.

Quick facts

• Study type: Observational
• Enrollment: 25 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University of Pittsburgh (Academic / other)
• Locations: 1 site (Pittsburgh, Pennsylvania)
• Trial ID: NCT06511999 on ClinicalTrials.gov

What this trial studies

Adults who achieve return of spontaneous circulation but remain comatose after cardiac arrest will undergo placement of a PediaSat oximetry catheter in the jugular vein to measure jugular venous oxygen saturation (SjO2). Some patients will have continuous SjO2 monitoring while others will have intermittent blood-sample-based measurements using the same catheter and hospital blood gas analysis. This observational protocol will record SjO2 trends alongside standard neurocritical care measures such as targeted temperature management, blood pressure, oxygenation, carbon dioxide targets, and EEG monitoring. The goal is to characterize between-patient heterogeneity in brain oxygen delivery after cardiac arrest to inform potential individualized neuroprotective treatments.

Who should consider this trial

Good fit: Adults (≥18 years) resuscitated from out-of-hospital or in-hospital cardiac arrest who remain comatose with motor Glasgow Coma Scale ≤4 off sedation for at least 30 minutes are ideal candidates.

Not a fit: Patients whose cardiac arrest was due to traumatic brain injury, intracranial bleeding, or ischemic stroke, those with unstable cervical spine fractures, extreme hemodynamic instability, moribund neurologic status, pregnancy, or incarceration are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, this could help clinicians detect episodes of inadequate brain oxygen delivery earlier and tailor treatments to each patient's needs, potentially improving neurologic recovery.

How similar studies have performed: Jugular venous oximetry and other neuromonitoring techniques are used clinically, but there is limited direct evidence that SjO2-guided management improves neurological outcomes after cardiac arrest, so this approach is relatively novel in terms of demonstrated benefit.

Eligibility criteria

Inclusion Criteria:

• Adults (\>=18 years old) resuscitated from out-of-hospital or in-hospital cardiac arrest who remain comatose (motor Glasgow coma scale \<=4) for at least 30 minutes when examined off sedation/neuromuscular blockade.

Exclusion Criteria:

* Cardiac arrest due to traumatic brain injury, intracranial bleeding, or ischemic stroke
* Cervical spine fracture
* Need for immediate prone positioning for severe hypoxemic respiratory failure
* Marked hemodynamic instability precluding priority of any neuromonitoring (multiple recurrent cardiac arrests, norepinephrine equivalents \> 1.5 mcg/kg/min)
* Moribund neurological status based upon initial clinical, radiographic and historical assessment (e.g. diffuse cerebral edema or herniation on head computed tomography)
* Pregnancy
* Prisoners

Where this trial is running

Pittsburgh, Pennsylvania

• UPMC Presbyterian Hospital — Pittsburgh, Pennsylvania, United States (Recruiting)

Study contacts

• Principal investigator: Byron Drumheller, MD — University of Pittsburgh
• Study coordinator: Byron Drumheller, MD

Conditions Cardiac Arrest; Jugular venous oxygen saturation; Neuromonitoring