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一项针对心脏骤停昏迷幸存者给予钙通道阻滞剂的随机临床试验。设计、方法及患者特征。脑复苏临床试验II研究组

A randomized clinical trial of calcium entry blocker administration to comatose survivors of cardiac arrest. Design, methods, and patient characteristics. The Brain Resuscitation Clinical Trial II Study Group.

出版信息

Control Clin Trials. 1991 Aug;12(4):525-45. doi: 10.1016/0197-2456(91)90011-a.

Abstract

The Brain Resuscitation Clinical Trial (BRCT) II was a double-masked, randomized, controlled clinical study of cardiopulmonary-cerebral resuscitation (CPCR) designed to test therapy for the amelioration of brain damage after cardiac arrest. Lidoflazine, a calcium entry blocker, was chosen for investigation because of its beneficial effects on postischemic encephalopathy in animals, its minimal cardiovascular depressant effects, and its protective actions in myocardial ischemia in patients. Twenty-four hospitals in eight countries participated. Over 4 years, 520 patients were recruited, of whom 4 were subsequently lost to follow-up. Patients' age averaged 63 years and 62% were men. Cardiac arrest occurred prior to hospitalization in 63%. All patients received basic and advanced life support until circulation was restored, and then standardized extracerebral organ support. After restoration of spontaneous circulation with normal blood pressure, patients who failed to awaken were randomly assigned to receive IV administration of either lidoflazine or placebo. In each patient, outcome was evaluated by cerebral performance during a 6-month follow-up period. Periodic safety monitoring was carried out to assure that no excess of mortality or complications occurred in the lidoflazine-treated group compared with the placebo-treated group.

摘要

脑复苏临床试验(BRCT)II是一项关于心肺脑复苏(CPCR)的双盲、随机、对照临床研究,旨在测试改善心脏骤停后脑损伤的治疗方法。利多氟嗪是一种钙通道阻滞剂,因其对动物缺血性脑病有有益作用、对心血管的抑制作用极小以及对患者心肌缺血有保护作用而被选作研究对象。八个国家的24家医院参与了该研究。在4年多的时间里,招募了520名患者,其中4名患者随后失访。患者平均年龄为63岁,男性占62%。63%的患者在住院前发生心脏骤停。所有患者均接受基础和高级生命支持,直至恢复循环,然后接受标准化的脑外器官支持。在血压恢复正常且自主循环恢复后,未苏醒的患者被随机分配接受静脉注射利多氟嗪或安慰剂。对每名患者在6个月的随访期内通过脑功能进行预后评估。进行定期安全性监测,以确保与安慰剂治疗组相比,利多氟嗪治疗组不会出现过多的死亡或并发症。

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