FEMART-1 Pilot Study (FEMART-1)
The FEMART-1 Pilot Study is focused on evaluating the feasibility, safety, and procedural timing of prehospital femoral arterial sheath placement in patients with non-traumatic out-of-hospital cardiac arrest (OHCA), both during ongoing cardiopulmonary resuscitation and after return of spontaneous circulation (ROSC).
The primary objective of the study is to enable invasive arterial blood pressure monitoring for targeted and continuous hemodynamic management using vasopressor therapy in the prehospital setting. The study evaluates the feasibility, safety, and procedural performance of invasive arterial monitoring with the aim of improving assessment of the patient's hemodynamic status and enabling more accurate titration of vasopressor support. This approach may reduce episodes of hypotension and decrease the risk of recurrent cardiac arrest while allowing safer transport to specialized cardiac arrest centers.
Femoral arterial access enables more precise monitoring of perfusion pressure, targeted vasopressor titration, and early recognition of impending circulatory collapse. The intervention may contribute to improved early organ perfusion and could be associated with more favorable neurological and overall clinical outcomes after cardiac arrest. In accordance with the ERC Guidelines 2025, which emphasize active hemodynamic optimization after ROSC and acknowledge the potential role of invasive arterial pressure monitoring during ongoing resuscitation, the study evaluates not only feasibility, safety, and procedural timing, but also the potential clinical benefit of continuous hemodynamic-guided management in the prehospital phase, including (1) early identification of hypotension, (2) targeted vasopressor administration, and (3) prevention of re-arrest.
The study is conducted by the Prague Air Rescue Service Kryštof 01 (Prague Emergency Medical Services) in collaboration with the Central Bohemian Emergency Medical Service, the Second Department of Internal Medicine - Cardiology and Angiology of the General University Hospital in Prague and First Faculty of Medicine, Charles University, and the Department of Anesthesiology, Resuscitation and Intensive Care Medicine of the General University Hospital in Prague and First Faculty of Medicine, Charles University.
FEMART-1 is designed as a prospective pilot study without external funding.
研究概览
地位
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名:Jan Spicak, MD
- 电话号码:00420776155836
- 邮箱:jan.spicak@zzshmp.cz
研究联系人备份
- 姓名:Silvie Trhlikova, MD, PhD
- 电话号码:MD 00420607610869
- 邮箱:silvie.trhlikova@zzshmp.cz
学习地点
-
-
-
Prague、捷克语、10100
- 招聘中
- EMS Prague
-
接触:
- Jan Spicak, MD
- 电话号码:+420776155836
- 邮箱:jan.spicak@zzshmp.cz
-
接触:
- Silvie Trhlikova, MD PhD
- 电话号码:+420607610869
- 邮箱:silvie.trhlikova@zzshmp.cz
-
-
参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
Inclusion Criteria:
* Non-traumatic out-of-hospital cardiac arrest (OHCA).
Patients meeting criteria for one of the following clinical scenarios:
Group A - ECPR-like group:
- Refractory cardiac arrest, including cardiac arrest occurring in the presence of the EMS crew.
- Age 18-70 years.
- Effective bystander cardiopulmonary resuscitation.
- Initial rhythm of ventricular fibrillation (VF), pulseless ventricular tachycardia (pVT), or pulseless electrical activity (PEA).
Group B - post-ROSC group:
- Return of spontaneous circulation (ROSC) after non-traumatic OHCA.
- Age 18-70 years.
Exclusion Criteria:
- Trauma as the probable primary cause of cardiac arrest.
Known severe comorbidity, including:
- terminal stage of incurable disease (advanced malignancy, advanced dementia, terminal pulmonary disease, terminal heart failure, or palliative care status),
- established do-not-resuscitate (DNR) status,
- severe pre-existing neurological disability (CPC 3 or CPC 4),
- known severe peripheral arterial disease or known occlusion of lower limb arteries,
- suspected pulmonary embolism with indication for thrombolytic therapy,
- known severe hematological disease associated with severe thrombocytopenia,
- morbid obesity.
- Known or suspected pregnancy.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:非随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
有源比较器:Prehospital Femoral Arterial Sheath Insertion
Patients receive standard advanced prehospital resuscitation and post-resuscitation care including ultrasound-guided femoral arterial sheath insertion for invasive blood pressure monitoring and potential facilitation of subsequent VA-ECMO cannulation if clinically indicated.
|
Ultrasound-guided placement of a femoral arterial sheath in the prehospital setting during ongoing cardiopulmonary resuscitation or after return of spontaneous circulation.
The procedure is performed to enable invasive arterial blood pressure monitoring, optimization of hemodynamic management during ongoing cardiopulmonary resuscitation or post-resuscitation care, prevention of re-arrest, and to facilitate rapid transition to potential VA-ECMO cannulation if clinically indicated.
其他名称:
|
|
无干预:Standard Prehospital Care
Patients receive standard advanced prehospital resuscitation and post-resuscitation care without prehospital femoral arterial sheath insertion.
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Percentage of Patients With Successful and Functional Invasive Arterial Blood Pressure Monitoring
大体时间:During prehospital care until hospital arrival
|
Feasibility of prehospital femoral arterial sheath placement expressed as the percentage of patients with successfully established and functional invasive arterial blood pressure monitoring among patients in whom prehospital femoral arterial sheath placement was attempted following a clinical decision to perform the procedure.
|
During prehospital care until hospital arrival
|
|
Percentage of Patients With Major Procedure-Related Complications
大体时间:From sheath insertion until hospital admission
|
Safety of prehospital femoral arterial sheath placement expressed as the percentage of patients with major procedure-related complications among patients in whom prehospital femoral arterial sheath placement was attempted following a clinical decision to perform the procedure.
Major complications include clinically significant bleeding, vascular injury, distal limb ischemia, or sheath-related complications requiring therapeutic intervention.
|
From sheath insertion until hospital admission
|
|
Procedural Time Characteristics of Prehospital Femoral Arterial Sheath Placement
大体时间:During prehospital care until hospital arrival
|
Assessment of procedural time characteristics of prehospital femoral arterial sheath placement among patients in whom the procedure was attempted following a clinical decision to perform the intervention.
Time intervals are assessed using predefined procedural time points recorded during the intervention.
|
During prehospital care until hospital arrival
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Use of Vasopressor or Inotropic Therapy in the Prehospital Setting
大体时间:During prehospital care until hospital arrival
|
Comparison of the number and proportion of patients receiving vasopressor or inotropic therapy during prehospital care.
|
During prehospital care until hospital arrival
|
|
Recognition of Impending Hemodynamic Collapse After ROSC
大体时间:During prehospital care until hospital arrival
|
Comparison of the number and proportion of patients with return of spontaneous circulation who develop hypotension (MAP below 50 mmHg) associated with re-initiation of cardiopulmonary resuscitation, initiation of vasopressor therapy, or escalation of ongoing vasopressor therapy during prehospital care.
|
During prehospital care until hospital arrival
|
|
Prehospital Re-arrest Rate
大体时间:During prehospital care until hospital arrival
|
Comparison of the number and proportion of patients requiring defibrillation or manual/mechanical cardiopulmonary resuscitation after previously achieved return of spontaneous circulation during prehospital care.
|
During prehospital care until hospital arrival
|
|
In-Hospital Re-arrest Within 20 Minutes After Handover
大体时间:Within 20 minutes after hospital admission
|
Comparison of the number and proportion of patients transferred to the receiving hospital with return of spontaneous circulation who subsequently require defibrillation or manual/mechanical cardiopulmonary resuscitation within 20 minutes after hospital handover.
|
Within 20 minutes after hospital admission
|
|
Adequate Mean Arterial Pressure at Hospital Handover
大体时间:At hospital admission
|
Comparison of the number and proportion of patients with mean arterial pressure above 60 mmHg at hospital handover.
|
At hospital admission
|
|
Blood Lactate Level at Hospital Admission
大体时间:At hospital admission
|
Comparison of median and mean lactate levels measured at hospital admission.
|
At hospital admission
|
|
Heart Rate at Hospital Admission
大体时间:At hospital admission
|
Comparison of median and mean heart rate measured at hospital admission.
|
At hospital admission
|
|
Survival and Neurological Clinical Outcomes
大体时间:Through hospital discharge (up to 30 days) and at 30 days after the index event
|
Comparison of the number and percentage of patients surviving to hospital discharge, surviving with favorable neurological outcome defined as Cerebral Performance Category (CPC) 1-2 at hospital discharge, and surviving 30 days after the index event.
|
Through hospital discharge (up to 30 days) and at 30 days after the index event
|
合作者和调查者
合作者
调查人员
- 首席研究员:Jan Spicak, MD、Prague Emergency Medical Services
出版物和有用的链接
一般刊物
- Ule J, Huppe T, Thiel J, Berwanger U, Schlechtriemen T, Conrad D, Merscher B. Implementing prehospital invasive arterial blood pressure monitoring in critically ill patients-a prospective observational first year analysis. Scand J Trauma Resusc Emerg Med. 2025 Sep 2;33(1):145. doi: 10.1186/s13049-025-01461-9.
- Butterfield ED, Price J, Bonsano M, Lachowycz K, Starr Z, Edmunds C, Barratt J, Major R, Rees P, Barnard EBG. Prehospital invasive arterial blood pressure monitoring in critically ill patients attended by a UK helicopter emergency medical service- a retrospective observational review of practice. Scand J Trauma Resusc Emerg Med. 2024 Mar 12;32(1):20. doi: 10.1186/s13049-024-01193-2.
- Wildner G, Pauker N, Archan S, Gemes G, Rigaud M, Pocivalnik M, Prause G. Arterial line in prehospital emergency settings - A feasibility study in four physician-staffed emergency medical systems. Resuscitation. 2011 Sep;82(9):1198-201. doi: 10.1016/j.resuscitation.2011.05.002. Epub 2011 May 11.
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
关键字
其他相关的 MeSH 术语
其他研究编号
- ZZSHMP_001_2026
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 计划说明
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.