Peripheral pULSe Assessment and Arterial pRessure (PULSAR)

NCT07609095 | Recruiting

• 1 other identifier: 2026-02475-01
• Study Type: observational
• Target: 5,000
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective multicenter observational study aims to investigate the relationship between palpable peripheral pulses and simultaneously measured arterial blood pressure in adult patients with circulatory shock or impending circulatory failure. Peripheral pulse palpation is routinely used in emergency medicine, trauma care, critical care, and cardiopulmonary resuscitation as a rapid clinical assessment of circulation. However, the association between palpable pulses and actual arterial blood pressure remains poorly validated. Patients treated in emergency departments, intensive care units, operating rooms, and other acute care settings will undergo routine pulse palpation at predefined anatomical locations including carotid, femoral, and radial arteries. Simultaneously measured non-invasive and/or invasive arterial blood pressure values will be recorded from routine clinical monitoring systems. Additional clinical variables relevant to circulatory status will also be collected. The study seeks to define blood pressure thresholds associated with pulse palpability and evaluate the agreement between invasive and non-invasive blood pressure measurements in patients with circulatory shock.

Conditions

Circulatory Shock; Hemodynamic Instability; Hypotension; Shock; Critical Illness

Keywords

Circulatory Shock; Hemodynamic Monitoring; Pulse Palpation; Peripheral Pulse; Arterial Blood Pressure; Hypotension; Critical Care; Trauma; Resuscitation; Hemodynamic Instability

Outcome Measures

Primary Outcomes (1)

• Association between palpable pulses and systolic arterial blood pressure

  Relationship between palpable carotid, femoral, and radial pulses and simultaneously measured systolic arterial blood pressure.

  During episodes of circulatory instability, up to 24 hours after inclusion

Secondary Outcomes (3)

• Mean arterial pressure associated with pulse palpability

  During episodes of circulatory instability, up to 24 hours after inclusion

• Agreement between non-invasive and invasive blood pressure measurements

  During episodes of circulatory instability, up to 24 hours after inclusion

• Effect of vascular disease and vasoactive medication on pulse palpability

  During hospital admission, up to 30 days

Study Arms (1)

Patients With Circulatory Shock

Adult patients with clinical signs of circulatory shock or impending circulatory failure undergoing routine hemodynamic monitoring with non-invasive and/or invasive arterial blood pressure measurement during standard clinical care.

Procedure: Peripheral Pulse Palpation

Interventions

Peripheral Pulse Palpation PROCEDURE

Manual palpation of carotid, femoral, and radial pulses performed during routine clinical care in patients with circulatory instability. Simultaneous arterial blood pressure measurements are recorded from standard monitoring systems. No study-specific treatment or intervention is administered.

Patients With Circulatory Shock

Eligibility Criteria

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

Study Population

Adult patients with circulatory shock or impending circulatory failure treated in emergency departments, intensive care units, operating rooms, trauma centers, and other acute care settings.

You may qualify if:

• Clinical signs of circulatory shock or impending circulatory failure
• Availability of non-invasive and/or invasive arterial blood pressure monitoring
• Pulse palpation possible without interfering with emergency care

You may not qualify if:

• Peripheral vascular conditions preventing reliable pulse palpation
• Major extremity amputation affecting assessment sites
• Clinical situations where study procedures interfere with life-saving treatment

Sponsors & Collaborators

• Region Stockholm: lead

Study Sites (1)

Region Stockholm, all hospitals

Stockholm, Stockholm County, 11883, Sweden

RECRUITING

Related Publications (2)

• Gunther M, Dahlberg M, Rostami A, Azadali A, Arborelius UP, Linder F, Rostami E. Incidence, Demographics, and Outcomes of Penetrating Trauma in Sweden During the Past Decade. Front Neurol. 2021 Nov 15;12:730405. doi: 10.3389/fneur.2021.730405. eCollection 2021.

  PMID: 34867718 BACKGROUND

• Kim SH, Lilot M, Sidhu KS, Rinehart J, Yu Z, Canales C, Cannesson M. Accuracy and precision of continuous noninvasive arterial pressure monitoring compared with invasive arterial pressure: a systematic review and meta-analysis. Anesthesiology. 2014 May;120(5):1080-97. doi: 10.1097/ALN.0000000000000226.

  PMID: 24637618 BACKGROUND

MeSH Terms

Conditions

Shock; Hypotension; Critical Illness; Wounds and Injuries

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Vascular Diseases; Cardiovascular Diseases; Disease Attributes

Central Study Contacts

Mattias Günther, MD PhD

CONTACT

46812361000; mattias.gunther@ki.se

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD PhD Associate Professor

Study Record Dates

• First Submitted: May 13, 2026
• First Posted: May 27, 2026
• Study Start: June 1, 2026
• Primary Completion (Estimated): June 1, 2031
• Study Completion (Estimated): December 31, 2031
• Last Updated: May 27, 2026

Record last verified: 2026-05

Locations

SE (1)