Resting Energy Expenditure and Substrate Consumption in Cardiac Arrest Patients Under Target Temperature Management
This study examines how the body uses energy and burns different fuels in patients who have experienced cardiac arrest and are being treated with controlled temperature management. Researchers will measure these metabolic processes to better understand how to care for these critically ill patients.
Key Objective: The trial aims to improve understanding of energy metabolism in cardiac arrest patients to potentially optimize treatment and recovery outcomes.
Who to Consider: Patients who have been successfully resuscitated from cardiac arrest and are receiving temperature management therapy in an intensive care unit may be candidates for this study.
Trial Parameters
Brief Summary
This study is a single-center, prospective, observational study. According to the sample size formula, an estimated 40 cases should be collected, all of whom are from the emergency intensive care unit. After successful cardiopulmonary resuscitation, the enrolled patients will be transferred to the emergency intensive care unit for further standardized target temperature management (TTM). They will be divided into 33 ° C hypothermia group and 36 ° C hypothermia group according to the patient's core body temperature. The baseline data of the patients will be collected at the beginning. After admission to the hospital, they were fasted within 24 hours to reach the target temperature, and then 20kcal/kg/d parenteral nutrition will be given. At selected time points (T0: the initial time point before TTM; T1: the core temperature was reduced to 33 ° C or 36 ° C; T2-T4: 33 ° C or 36 ° C was maintained for 24h, 48h, 72h; T5: the end of rewarming; Tend: the last REE measurement before discharge or death) , various observation indicators will be collected, including resting energy expenditure (REE), glucose oxidation rate, fat oxidation rate, protein oxidation rate, and metabolism of three major nutrients Proportion. Neurological outcomes were followed up 28 days after onset according to the Cerebral Performance Categories (CPC) score.
Eligibility Criteria
Inclusion Criteria: * Be admitted to the emergency department of Beijing Chao-yang Hospital, Capital Medical University; * Successfully resuscitated, and are unconscious after restoration of spontaneous circulation (ROSC); * Be admitted to the intensive care unit (ICU) for advanced life support such as endotracheal intubation after restoration of spontaneous circulation (ROSC); * Accepted target temperature management (TTM) therapy after restoration of spontaneous circulation (ROSC); Exclusion Criteria: * Age \> 18 years old； * Incomplete clinical data and loss of follow-up; * Traumatic brain injury or cerebrovascular accident revealed by computed tomography (CT)； * Severe metabolic abnormalities are known: cachexia, thyroid dysfunction, and cancer； * Indirect calorimetry measurement is not possible such as sustained oxygen concentration \> 70%； * There were no signs of resuscitation at the time of admission；