Research Group Hänggi

CARIB Cardiac Arrest Research Inselspital Bern

Main Areas of Work

  • Cardiovascular arrest, resuscitation, primary survival with REBOA
  • Cardiovascular arrest: post-reanimation – outcome prediction, treatment
  • Preparation and development of experimental platforms
  • Clinical projects in neurology and trauma, sedation, delirium

Brief description

Fewer than 10% of patients with cardiovascular arrest survive with a good neurological outcome. Our objective has beento increase this value – on the basis of our experience in our large clinical centre, with more than 100 patients per yearafter reanimation and with our well equipped experimental laboratory.

Within our clinic, we work with a catheter (REBOA) that diverts the blood flow produced by the cardiac massage into thebrain and heart. Our participation in the international studies TTM2 and TAME should help us to define the optimal follow-up treatment.

Our assessment of the prognosis is based on the new «functional» tests in EEG and MRI. We have set up a database forour patients. This will help us to analyse scientifically how any changes in the treatment concept may influence theoutcome. In our preclinical research, we are experimenting with «neuroprotective» substances administered afterreanimation. We have administered various anaesthetics, the noble gases argon and helium, as well as α-pifithrin, whichinhibits programmed cell death (apoptosis). The latter substance has given the most promising results.

We are currently working on a carrier of free oxygen that is produced by the lugworm, in the hope that this could improvethe supply of oxygen to the brain and heart in our rat model. We have also attempted therapy with neuronal stem cellsand have shown that these migrate to the site of the damage, where they may be integrated.

Our greatest advantage is our extensive experience. We exploit the platform for experimental studies performed in theUniversity Department of Intensive Care and have succeeded in developing and implementing experiments with small andlarge animals, as described for other applications.

Another focus of our work is on the care of patients with craniocerebral injuries. Our participation in the (completed)POLAR trial has shown that early hypothermia after craniocerebral injury is not advantageous. The international BonANZatrial will compare two treatment concepts and will include the measurement of cerebral oxygen.

Associated staff

Dr. med. Manuela Iten
Leadership team

Dr. med. Anja Levis
Leadership team

Dr. med. Michael Glas
.

Dr. med. Manuel Kindler
.

Current projects

  • TAME Cardiac Arrest Study, ClinicalTrials.gov Identifier: NCT03114033
  • TTM2 Trial, ClinicalTrials.gov Identifier: NCT02908308
  • CPR-REBOA, Improvement of blood pressure, NIRS and outcome with REBOA in out-of-hospital cardiac arrest
  • Implementation of an Utstein-Style database for cardiac arrest patients in Bern
  • Eurostar, «high-density» EEG for Prognostication after cardiac arrest
  • Functional MRI (fMRI) for prognostication in patients after cardiac arrest
  • Effects of the new artificial oxygen carrier Hemarina M101 neuronal injury in transient ischemia in a rodent cardiac arrest model
  • The SAnDMAN study Sedation, Analgesia and Delirium MANagement, ESICM
  • BRAIN OXYGEN NEUROMONITORING IN AUSTRALIA AND NEW ZEALAND ASSESSMENT
  • THE BONANZA TRIAL Clinical Trial Identifier: ACTRN12619001328167P

Important publications

Collaborations

Inselspital, Bern University Hospital

  • University Institute for Diagnostic and Interventional Neuroradiology (F. Wagner, MD)
  • Department of Neurology (F. Zubler, MD)

National Collaborations

  • Centre for Research in Neuroscience, Department of Clinical Neurosciences, CHUV – UNIL, Lausanne (M. De Lucia, PhD PD, Head of EEG imaging)

International Collaborations

  • Emergency Medicine, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA (J. Daley, MD)