Molecular Insights Into Post-Cardiac Arrest Brain Injury Via CSF Multi-Omics (PCABI-OMICS)

Identification of Novel Molecular Pathophysiological Mechanisms of Secondary Brain Injury in Post-cardiac Arrest Syndrome Patients Using Cerebrospinal Fluid Multi-omics Analysis

The goal of this study is to uncover the molecular mechanisms responsible for secondary brain injury in patients with post-cardiac arrest syndrome by analyzing cerebrospinal fluid (CSF) using multi-omics techniques.

The main question this study aims to answer is:

Which genome-, transcriptome-, proteome-, and metabolome-level changes in CSF are associated with secondary brain injury after cardiac arrest?

To address this question, CSF samples collected from post-cardiac arrest patients will undergo multi-omics analyses. Identified molecular pathways will be used to screen existing drug databases and generate new therapeutic candidates through computational modeling and compound synthesis. These findings will provide the scientific foundation needed to design and implement future preclinical experiments using cardiac arrest animal models.

Study Overview

• Status: Recruiting
• Conditions: Cardiac Arrest (CA); Cerebrospinal Fluid; Multiomics; Hypoxic-Ischemic Brain Injury

• Study Type: Observational
• Enrollment (Estimated): 60

Contacts and Locations

• Study Contact: Name: Changshin Kang, MD. PhD; Phone Number: +821089928386; Email: rosc@cnu.ac.kr

Study Locations

• South Korea
  • Jung-gu
    • Daejeon, Jung-gu, South Korea, 35015
      • Recruiting
      • Chungnam National University Hospital
      • Contact: Jiyoung Choi; Phone Number: +82-42-280-6713; Email: rosc@cnu.ac.kr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population for this research consists of a highly specific and clinically critical group of patients: Adults who have experienced out-of-hospital or in-hospital cardiac arrest and successfully regained spontaneous circulation (ROSC), but remain at high risk for secondary brain injury.

Description

Inclusion Criteria:

• Patients receiving post-resuscitation care after out-of-hospital cardiac arrest for secondary brain injury treatment.
• Patients without contraindications for lumbar puncture catheter insertion for cerebrospinal fluid (CSF) collection. This includes the absence of:
• Uncontrolled diabetes.Coagulation disorders.
• Thrombocytopenia (platelet count $< 100,000).
• A history of cirrhosis diagnosis.
• Current receipt of low molecular weight heparin.
• Current use of platelet inhibitors.
• A history of posterior spinal fusion that may interfere with catheter insertion.
• Local skin infection or rash at the puncture site.
• Signs of systemic infection or sepsis.
• A history of lumbar puncture within the past 6 hours.

Exclusion Criteria:

• Cerebral Edema: Patients with evidence of cerebral edema on a brain computed tomography (CT) scan performed immediately after spontaneous circulation recovery.
• Patients who underwent extracorporeal membrane oxygenation (ECMO).
• Patients who could not maintain integrated therapy for more than 24 hours after cardiac arrest.
• Patients with a history of acute or chronic brain disease.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Favorable neurological outcome; The favorable neurological outcome group is classified as patients with a CPC score of 1 or 2 upon long-term follow-up (at discharge, 3 months after post-resuscitation)
Unfavorable neurological outcome; The favorable neurological outcome group is classified as patients with a CPC score of 3 to 5 upon long-term follow-up (at discharge, 3 months after post-resuscitation)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neurological outcome	Neurological outcome assessed using the Cerebral Performance Category (CPC) scale (range 1-5; lower scores indicate better neurological function).	at discharge (assessed up to 3 days), 3 months after return of spontaneous circulation (ROSC)

Collaborators and Investigators

• Sponsor: Chungnam National University Hospital

Publications and helpful links

General Publications

• 5. Edgren E, Enblad P, Grenvik A, et al. Cerebral blood flow and metabolism after cardiopulmonary resuscitation. A pathophysiologic and prognostic positron emission tomography pilot study. Resuscitation 2003;57:161-70.
• 4. Buunk G, van der Hoeven JG, Meinders AE. Cerebral blood flow after cardiac arrest. Neth J Med 2000;57:106-12.
• Madl C, Holzer M. Brain function after resuscitation from cardiac arrest. Curr Opin Crit Care. 2004 Jun;10(3):213-7. doi: 10.1097/01.ccx.0000127542.32890.fa.
• 1. Wiklund LM, Miclescu A, Semenas E, Rubertsson S, Sharma HS. Central nervoustissue damage after hypoxia and reperfusion in conjunction with cardiac arrest and cardiopulmonary resuscitation: mechanisms of action and possibilities for mitigation. Int Rev Neruobiol 2012;102:173-87.

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2025
• Primary Completion (Estimated): November 30, 2027
• Study Completion (Estimated): February 28, 2028

Study Registration Dates

• First Submitted: November 27, 2025
• First Submitted That Met QC Criteria: March 16, 2026
• First Posted (Actual): March 18, 2026

Study Record Updates

• Last Update Posted (Actual): March 18, 2026
• Last Update Submitted That Met QC Criteria: March 16, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Heart Diseases; Brain Ischemia; Signs and Symptoms, Respiratory; Hypoxia, Brain; Hypoxia; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Heart Arrest; Hypoxia-Ischemia, Brain
• Other Study ID Numbers: CNUH-2025-07-044-003; RS-2025-00554697 (Other Grant/Funding Number: National Research Foundation of Korea)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No