About this trial
OHCA is a critical medical emergency with significant mortality and morbidity primarily due to hypoxic-ischemic brain injury (HIBI). Despite advances in resuscitation techniques, the neurological outcomes for survivors remain poor. Current post-resuscitation practices lack specific neuroprotective strategies. Ketamine, an N-Methyl-D-Aspartate (NMDA) receptor antagonist, has shown potential neuroprotective properties in preclinical and clinical studies due to its ability to inhibit excitotoxicity and reduce neuronal apoptosis. This trial hypothesizes that ketamine, when used for sedation in OHCA patients, may offer superior neuroprotective benefits compared to the commonly used sedative propofol. By comparing the effects of ketamine and propofol on neuronal damage markers and long-term neurological outcomes, this study aims to identify a potentially effective intervention to improve the prognosis of OHCA patients.
Eligibility criteria
Qualifiers
Adults (age ≥18 years) AND
resuscitated OHCA of presumed cardiac cause with a shockable first recorded heart rhythm AND
mean arterial pressure (MAP) >40 mmHg AND
a decision to perform prehospital intubation.
Disqualifiers
Advanced life support termination-of-resuscitation (TOR) criteria met
Systolic blood pressure >190 mmHg
Known allergy to ketamine or propofol
Chronic diseases making 180-day survival unlikely
Trial design
Treatments tested in this trial
- esketamine hydrochloride
- propofol
Treatment groups
Sponsors and collaborators
Christian Hassager
Lead sponsor
Rigshospitalet, Denmark
Sponsor institution