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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03114033
Registration number
NCT03114033
Ethics application status
Date submitted
11/04/2017
Date registered
14/04/2017
Titles & IDs
Public title
Targeted Therapeutic Mild Hypercapnia After Resuscitated Cardiac Arrest
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Scientific title
TAME Cardiac Arrest Trial: Targeted Therapeutic Mild Hypercapnia After Resuscitated Cardiac Arrest: A Phase III Multi-Centre Randomised Controlled Trial
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Secondary ID [1]
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ANZIC-RC/SB001
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Universal Trial Number (UTN)
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Trial acronym
TAME
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Out-Of-Hospital Cardiac Arrest
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Condition category
Condition code
Cardiovascular
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Coronary heart disease
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Cardiovascular
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Other cardiovascular diseases
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Respiratory
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Other interventions - Targeted therapeutic mild hypercapnia
Other interventions - Targeted normocapnia (Standard care)
Experimental: Targeted therapeutic mild hypercapnia - Target arterial carbon dioxide range of 50-55 mmHg for 24 hours following randomisation
Active comparator: Targeted normocapnia (Standard care) - Target arterial carbon dioxide range of 35-45 mmHg for 24 hours following randomisation
Other interventions: Targeted therapeutic mild hypercapnia
Patients allocated to the TTMH protocol will be sedated to achieve moderate to deep sedation (a target Richmond Agitation Scale Score of -4). Arterial blood gases and end- tidal carbon dioxide levels will be measured at baseline and then used to guide respiratory rate adjustments of minute ventilation to remain within the target PaCO2 range of 50-55 mmHg. Arterial blood gases will be repeated every 4 hours for 24 hours following randomisation or if end-tidal carbon dioxide values change \>5 mmHg
Other interventions: Targeted normocapnia (Standard care)
Patients allocated to the standard care (TN) protocol will be managed according to current practice and in accordance with ILCOR guidelines which recommend maintaining normocapnia in these patients. They will be sedated to achieve moderate to deep sedation (a target Richmond Agitation Scale Score of - 4). Arterial blood gases and end-tidal carbon dioxide levels will be measured at baseline and then used to guide respiratory rate adjustments of minute ventilation to remain within the target PaCO2 range of 35-45 mmHg. Arterial blood gases will be repeated every 4 hours for 24 hours following randomisation or if end-tidal carbon dioxide values change \>5 mmHg.
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Intervention code [1]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Neurological outcome
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Assessment method [1]
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Proportion of patients with a favourable (score =5) neurological outcome as assessed using the Glasgow Outcomes Score Extended (GOSE) method.
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Timepoint [1]
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6 months following enrolment
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Secondary outcome [1]
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Mortality at intensive care unit discharge
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Assessment method [1]
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Mortality at intensive care unit discharge
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Timepoint [1]
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6 months after randomisation
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Secondary outcome [2]
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Mortality at hospital discharge
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Assessment method [2]
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Mortality at hospital discharge
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Timepoint [2]
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6 months after randomisation
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Secondary outcome [3]
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Health-related Quality of Life (EQ-5D-5L)
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Assessment method [3]
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Health-related Quality of Life (EQ-5D-5L) at 6 months
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Timepoint [3]
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6 months after randomisation
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Secondary outcome [4]
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modified Rankin scale (mRS)
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Assessment method [4]
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modified Rankin scale (mRS) with favourable score of equal to or less than 3
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Timepoint [4]
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6 months after randomisation
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Secondary outcome [5]
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Montreal Cognitive Assessment (MoCA-blind)
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Assessment method [5]
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Montreal Cognitive Assessment (MoCA-blind) at 6 months
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Timepoint [5]
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6 months after randomisation
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Secondary outcome [6]
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Mortality at 6 months
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Assessment method [6]
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Mortality at 6 months
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Timepoint [6]
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6 months after randomisation
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Secondary outcome [7]
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Informant Questionnaire on Cognitive Decline in the Elderly-Cardiac Arrest (IQCODE)
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Assessment method [7]
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IQCODE
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Timepoint [7]
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6 months after randomisation
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Secondary outcome [8]
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Symbol Digit Modality Test
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Assessment method [8]
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SDMT at 6 months
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Timepoint [8]
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6 months after randomisation
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Eligibility
Key inclusion criteria
* Adult (age =18 years or older)
* Out-of-hospital cardiac arrest of a presumed cardiac or unknown cause
* Sustained ROSC - defined as 20 minutes with signs of circulation without the need for chest compressions
* Unconscious (FOUR-score motor response of <4, not able to obey verbal commands after sustained ROSC) (Appendix D)
* Eligible for intensive care without restrictions or limitations
* Within <180 minutes of ROSC
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Unwitnessed cardiac arrest with an initial rhythm of asystole
* Temperature on admission <30oC
* On ECMO prior to ROSC
* Obvious or suspected pregnancy
* Intracranial bleeding
* Severe chronic obstructive pulmonary disorder (COPD) with long-term home oxygen therapy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
UNKNOWN
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
15/02/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/12/2022
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Actual
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Sample size
Target
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Accrual to date
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Final
1700
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Recruitment in Australia
Recruitment state(s)
NSW,NT,QLD,SA,VIC
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Recruitment hospital [1]
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St Vincent's Hospital Sydney - Darlinghurst
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Nepean Hospital - Penrith
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Royal North Shore Hospital - St Leonards
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Wollongong Hospital - Wollongong
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Royal Darwin Hospital - Tiwi
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Royal Brisbane and Women's Hospital - Brisbane
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Princess Alexandra Hospital - Brisbane
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Prince Charles Hospital - Chermside
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Gold Coast University Hospital - Southport
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Nambour Hospital - Sunshine Coast
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Sunshine Coast University Hospital - Sunshine Coast
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Flinders Medical Centre - Adelaide
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Ballarat Base Hospital - Ballarat
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The Northern Hospital - Epping
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University Hospital Geelong - Geelong
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Recruitment hospital [16]
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Alfred Health - Melbourne
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Footscray Hospital-Western Health - Melbourne
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Sunshine Hospital-Western Health - Melbourne
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Recruitment hospital [19]
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Royal Melbourne Hospital - Melbourne
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Recruitment hospital [20]
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Austin Health - Melbourne
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Recruitment postcode(s) [1]
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2010 - Darlinghurst
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Recruitment postcode(s) [2]
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2750 - Penrith
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Recruitment postcode(s) [3]
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2065 - St Leonards
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Recruitment postcode(s) [4]
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2500 - Wollongong
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Recruitment postcode(s) [5]
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0810 - Tiwi
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Recruitment postcode(s) [6]
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4029 - Brisbane
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Recruitment postcode(s) [7]
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4102 - Brisbane
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Recruitment postcode(s) [8]
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4032 - Chermside
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Recruitment postcode(s) [9]
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4215 - Southport
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Recruitment postcode(s) [10]
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4560 - Sunshine Coast
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Recruitment postcode(s) [11]
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4575 - Sunshine Coast
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Recruitment postcode(s) [12]
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3929 - Adelaide
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Recruitment postcode(s) [13]
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3350 - Ballarat
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Recruitment postcode(s) [14]
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3076 - Epping
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Recruitment postcode(s) [15]
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- Geelong
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Recruitment postcode(s) [16]
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3004 - Melbourne
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Recruitment postcode(s) [17]
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3011 - Melbourne
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Recruitment postcode(s) [18]
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3021 - Melbourne
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Recruitment postcode(s) [19]
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3050 - Melbourne
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Recruitment postcode(s) [20]
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3084 - Melbourne
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Recruitment outside Australia
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Belgium
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State/province [1]
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Bruxelles
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Belgium
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Genk
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Belgium
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Gent
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Denmark
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Aarhus
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Finland
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Helsinki
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France
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Franche Comte
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Ireland
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Dublin
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Ireland
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Galway
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Italy
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Milan
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Netherlands
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Amsterdam
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New Zealand
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Auckland
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New Zealand
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Christchurch
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New Zealand
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Wellington
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New Zealand
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Rotorua
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Norway
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Oslo
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Saudi Arabia
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Riyadh
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Slovenia
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Maribor
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Sweden
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Helsingborg
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Sweden
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Malmö
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United Kingdom
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Portsmouth
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United Kingdom
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Belfast
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United Kingdom
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Birmingham
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United Kingdom
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Bournemouth
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United Kingdom
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Bristol
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United Kingdom
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Cardiff
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United Kingdom
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Manchester
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United Kingdom
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Reading
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Funding & Sponsors
Primary sponsor type
Other
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Name
Australian and New Zealand Intensive Care Research Centre
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Address
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Other collaborator category [1]
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Other
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Name [1]
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National Health and Medical Research Council, Australia
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Address [1]
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Other collaborator category [2]
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Other
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Name [2]
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Health Research Board, Ireland
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Address [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
The TAME Cardiac Arrest trial will study the ability of higher arterial carbon dioxide (PaCO2) levels to reduce brain damage, comparing giving patients 'normal' to 'slightly higher than normal' blood PaCO2 levels and assessing their ability to return to normal life-tasks. It will be the largest trial ever conducted in heart attack patients in the intensive care unit. This therapy is cost free and, if shown to be effective, will improve thousands of lives, transform clinical practice, and yield major savings.
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Trial website
https://clinicaltrials.gov/study/NCT03114033
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Trial related presentations / publications
Eastwood GM, Schneider AG, Suzuki S, Peck L, Young H, Tanaka A, Martensson J, Warrillow S, McGuinness S, Parke R, Gilder E, Mccarthy L, Galt P, Taori G, Eliott S, Lamac T, Bailey M, Harley N, Barge D, Hodgson CL, Morganti-Kossmann MC, Pebay A, Conquest A, Archer JS, Bernard S, Stub D, Hart GK, Bellomo R. Targeted therapeutic mild hypercapnia after cardiac arrest: A phase II multi-centre randomised controlled trial (the CCC trial). Resuscitation. 2016 Jul;104:83-90. doi: 10.1016/j.resuscitation.2016.03.023. Epub 2016 Apr 7.
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Public notes
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Contacts
Principal investigator
Name
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Glenn M Eastwood, RN, PhD
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Address
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Monash University
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Undecided
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Type
Citations or Other Details
Journal
Eastwood GM, Schneider AG, Suzuki S, Peck L, Young...
[
More Details
]
Results not provided in
https://clinicaltrials.gov/study/NCT03114033