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Peripheral pULSe Assessment and Arterial pRessure (PULSAR) (PULSAR)

14. august 2026 oppdatert av: Mattias Gunther, Region Stockholm

Association Between Palpable Peripheral Pulses and Arterial Blood Pressure in Patients With Circulatory Shock: An International Prospective Multicenter Observational Cohort Study

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.

Studieoversikt

Detaljert beskrivelse

The presence or absence of palpable peripheral pulses is widely used as a rapid bedside indicator of circulatory status during trauma care, emergency medicine, intensive care, and cardiopulmonary resuscitation. Advanced Trauma Life Support (ATLS) teaching traditionally assumes that palpable pulses at different anatomical sites correspond to specific systolic blood pressure thresholds. However, these assumptions are based on limited evidence from small observational studies.

This international multicenter prospective observational cohort study aims to investigate the relationship between palpable carotid, femoral, and radial pulses and simultaneously measured arterial blood pressure in adult patients with circulatory shock or impending circulatory failure.

Patients receiving routine hemodynamic monitoring with non-invasive blood pressure (NIBP) and/or invasive arterial blood pressure (IBP) monitoring will be included. Pulse palpation will be performed during routine clinical care without altering treatment or management.

The primary objective is to determine the association between pulse palpability and measured systolic blood pressure. Secondary objectives include identifying blood pressure thresholds associated with pulse palpability, evaluating agreement between invasive and non-invasive blood pressure measurements, and assessing whether patient factors such as vascular disease or vasoactive medication use influence pulse palpability.

Studietype

Observasjonsmessig

Registrering (Antatt)

5000

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

    • Stockholm County
      • Stockholm, Stockholm County, Sverige, 11883
        • Rekruttering
        • Region Stockholm, all hospitals
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

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.

Beskrivelse

Inclusion Criteria:

  • 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

Exclusion Criteria:

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
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.
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Association between palpable pulses and systolic arterial blood pressure
Tidsramme: During episodes of circulatory instability, up to 24 hours after inclusion
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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Mean arterial pressure associated with pulse palpability
Tidsramme: During episodes of circulatory instability, up to 24 hours after inclusion
Relationship between pulse palpability and mean arterial pressure (MAP).
During episodes of circulatory instability, up to 24 hours after inclusion
Agreement between non-invasive and invasive blood pressure measurements
Tidsramme: During episodes of circulatory instability, up to 24 hours after inclusion
Agreement between oscillometric non-invasive blood pressure and invasive arterial blood pressure measurements.
During episodes of circulatory instability, up to 24 hours after inclusion
Effect of vascular disease and vasoactive medication on pulse palpability
Tidsramme: During hospital admission, up to 30 days
Influence of peripheral vascular disease, atherosclerosis, age, and vasoactive medications on pulse palpability.
During hospital admission, up to 30 days

Samarbeidspartnere og etterforskere

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Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. juni 2026

Primær fullføring (Antatt)

1. juni 2031

Studiet fullført (Antatt)

31. desember 2031

Datoer for studieregistrering

Først innsendt

13. mai 2026

Først innsendt som oppfylte QC-kriteriene

19. mai 2026

Først lagt ut (Faktiske)

27. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

18. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

14. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

UBESLUTTE

IPD-planbeskrivelse

Data sharing plans are currently undecided due to ongoing considerations regarding ethical approvals, multicenter collaboration agreements, and data protection regulations.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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