Resuscitation and Capillary Reperfusion

NCT04791995 | Completed

• 1 other identifier: 001
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Persistent microperfusion alterations after return of spontaneous circulation (ROSC) are associated with poor survival. To our knowledge, no human studies evaluating microperfusion during cardiopulmonary resuscitation (CPR) with simple and pre-hospital available tests have been published. Capillary refill time (CRT) and skin-mottling-score (SMS) are parameters for microperfusion and evaluated in septic and cardiogenic shock. In animal studies, microperfusion was impaired during cardiac arrest, although not correlating with systemic blood pressure. The aim of this study is to investigate the correlation between impaired microcirculation (as measured with CRT and SMS) during resuscitation and ROSC resp. neurological outcome. Our clinical impression in daily routine is, that the appearance of a patient undergoing CPR is often linked to the outcome. We hypothesize, that this is due to changes in microperfusion of the skin.

Conditions

Cardiac Arrest; Cardiac Arrest, Out-Of-Hospital; Cardiopulmonary Arrest; Cardiopulmonary Arrest With Successful Resuscitation

Keywords

capillary refill time; skin mottling score; capillary lactate; microperfusion; cardiopulmonary resuscitation

Outcome Measures

Primary Outcomes (1)

• Capillary refill time (CRT)

  Capillary refill time in seconds measured on one finger and one earlobe for ROSC vs. no ROSC

  baseline (immediately after inclusion to the study)

Secondary Outcomes (10)

• Skin mottling score (SMS)

  baseline (immediately after inclusion to the study = minute 0), minute 2, 4, 6, 8, (...) up to return of spontaneous circulation or death, whichever came first

• Capillary blood lactate (Lac)

  baseline (immediately after inclusion to the study, = minute 0), minute 4, 8, 12, 16, 20

• Hospital mortality

  baseline (immediately after inclusion to the study)

• Correlation of CRT, SMS and Lac and 30 days good neurological outcome

  baseline (immediately after inclusion to the study)

• Correlation of CRT, SMS and Lac and hospital discharge good neurological outcome

  baseline (immediately after inclusion to the study)

Eligibility Criteria

• Age: 18 Years - 95 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult out-of-hospital cardiac arrest patients

You may qualify if:

• All patients ≥18 years during cardiopulmonary resuscitation
• witnessed cardiac arrest

You may not qualify if:

• insufficient manpower (e.g. study team has to provide CPR)
• hypovolemia (exsanguination, anaphylaxis, sepsis as underlying cause)
• presumed or known COVID-19 disease
• hypo-/hyperthermia (\<36.0°, \>37.5°C)
• Raynaud's disease
• Peripheral arterial disease

Sponsors & Collaborators

• Medical University of Vienna: lead

Study Sites (1)

Vienna Municipal Emergency Service

Vienna, Austria

Location

Related Publications (1)

• Mueller M, Holzer M, Losert H, Grassmann D, Ettl F, Gatterbauer M, Magnet I, Nuernberger A, Kienbacher CL, Gelbenegger G, Girsa M, Herkner H, Krammel M. The association of capillary refill time and return of spontaneous circulation during out-of-hospital cardiac arrest: an observational study. Crit Care. 2025 Jan 21;29(1):37. doi: 10.1186/s13054-025-05255-4.

  PMID: 39838473 DERIVED

MeSH Terms

Conditions

Heart Arrest; Out-of-Hospital Cardiac Arrest

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases

Study Officials

• Michael Holzer, MD

  Department of Emergency Medicine, Medical University of Vienna

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof. Michael Holzer

Study Record Dates

• First Submitted: March 2, 2021
• First Posted: March 10, 2021
• Study Start: March 3, 2021
• Primary Completion: March 31, 2022
• Study Completion: May 1, 2022
• Last Updated: September 26, 2022

Record last verified: 2022-09

Data Sharing

• IPD Sharing: Will not share

Locations

AU (1)