Treatment of ELectroencephalographic STatus Epilepticus After Cardiopulmonary Resuscitation-2 (TELSTAR-2)

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorUniversity of Twente

About this trial

The goal of this comparative effectiveness trial is to study electrographic status epilepticus (ESE) treatment in comatose patients after cardiac arrest. The main questions the trial aims to answer are:

* Does ESE treatment improve outcome? * What is the impact of ESE treatment on healthcare costs?

Participants in the the intervention group will receive standard care completed with anti-seizure treatment. The control group will receive standard care without anti-seizure treatment.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Coma (Glasgow Coma Scale score ≤ 8) after out of hospital cardiac arrest and resuscitation

Age ≥ 18 years

Continuous EEG with at least eight electrodes started < 24h after return of spontaneous circulation (ROSC)

ESE or possible ESE according to the Salzburg and ACNS criteria

Disqualifiers

Known history of another medical condition with limited life expectancy (< six months)

Any progressive brain illness, such as a brain tumor or neurodegenerative disease

Pre-admission Glasgow Outcome Scale score of 3 or lower

Reason other than the neurological condition to withdraw treatment

Trial design

Design model

Parallel

Treatments tested in this trial

  • anti-seizure medication + sedative agent(s)

    Drug

    Stepwise approach: 1. a single dose of a parenteral benzodiazepine (lorazepam, midazolam, or diazepam) and a first parenteral anti-seizure medication (levetiracetam, valproate, or lacosamide) 2. a second parenteral anti-seizure medication plus a first continuous parenteral sedative agent (midazolam or propofol) 3. a second continuous parenteral sedative agent (midazolam, propofol, or ketamine)

Treatment groups

150 Participants
are divided into 2 treatment groups
Group A: Intervention groupOther 1 intervention
Group B: Control groupNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

score on the extended Glasgow Outcome Scale (eGOS)

eGOS is an 8-points ordinal scale of functional recovery with possible scores ranging from 0 to 6. A higher score indicates better functional recovery

Time frame
6 months after cardiac arrest

Secondary outcomes

1

quality adjusted life years (QALYs)

this is a measure of cost-effectiveness

Time frame
12 months after cardiac arrest

Other outcomes

1

survival in months

this is a measure of survival

Time frame
12 months after cardiac arrest
2

death (any cause), pneumonia, sepsis (according to sepsis 3 criteria), bleeding (any cause), cardiac arrhythmia (any associated with hemodynamic compromise), new cardiac arrest, or thrombopenia

these are safety outcomes

Time frame
12 months after cardiac arrest
3

score on the Rankin Scale (mRS)

mRS is a 6-point ordinal functional recovery scale with possible scores ranging from 1 to 6. A lower score indicates better functional recovery.

Time frame
6 and 12 months after cardiac arrest
4

score on the cerebral performance categories (CPC)

COC is a 5-point ordinal functional recovery scale with possible scores ranging from 1 to 5. A lower score indicates better functional recovery.

Time frame
6 and 12 months after cardiac arrest

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

University of Twente

Lead sponsor

Erasme University Hospital

Collaborator

ZonMw: The Netherlands Organisation for Health Research and Development

Collaborator

Belgium Health Care Knowledge Centre

Collaborator