Resuscitative Endovascular Balloon Occlusion of the Aorta in Non-traumatic Out of Hospital Cardiac Arrest

NCT ID: NCT04596514

Last Updated: 2025-07-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-07

Study Completion Date

2026-07-31

Brief Summary

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The primary aim of this trial is to assess the efficacy of resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct treatment to advanced cardiovascular life support (ACLS) in patients with out-of-hospital cardiac arrest.

Out of hospital cardiac arrest (OHCA) carries a high mortality rate. The treatment of out-of-hospital cardiac arrest is ACLS as stated in the guidelines from the Norwegian Resuscitation Council and the European Resuscitation Guidelines.

Recently, REBOA has been proposed as an adjunct treatment in management of non-traumatic cardiac arrest patients, because thoracic aortic occlusion provides a redistribution of the cardiac output to organs proximal to the occlusion. Preclinical studies demonstrate that REBOA during CPR provide both increased coronary artery blood flow and perfusion pressure and increased rates of return of spontaneous circulation (ROSC).

This is the first prospective trial in the world to assess the efficacy of REBOA in non-traumatic cardiac arrest. The intervention is shown feasible in the pre-hospital setting. If this trial provides a signal of benefit in patients, this study could initiate further clinical research which could change current resuscitation practice world-wide.

Detailed Description

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This is a prospective, randomised, parallel group, multi-centre, phase II clinical trial.

Patients are randomised in a 1:1 ratio to be included to the control group or the intervention group. The control group receives ACLS according to national guidelines, while the intervention group receives ACLS according to national guidelines and the REBOA procedure as an adjunct treatment.

The REBOA procedure is performed by a team consisting of a physician (anesteshiologist) and a paramedic, working at a helicopter emergency medical service (HEMS) base. All operators will be properly educated and tested before they can include patients.

If the patients in the intervention group achieves ROSC, the balloon will be deflated and post-ROSC treatment will be continued as per routine.

Conditions

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Cardiac Arrest

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Blinded from the statisticians who carry out analyses

Study Groups

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Intervention group - REBOA

Resuscitative Balloon Occlusion of the Aorta after advanced cardiac life support if return of spontaneous circulation is not achieved

Group Type EXPERIMENTAL

REBOA

Intervention Type PROCEDURE

Resuscitative endovascular balloon occlusion of the aorta (REBOA)

usual procedure according to guidelines

Intervention Type PROCEDURE

Treatment as described in the guidelines from the European Resuscitation Council, the Norwegian Resuscitation Council, and other local national guidelines

Control group - ACLS

Advanced cardiovascular life support as described in the guidelines

Group Type ACTIVE_COMPARATOR

usual procedure according to guidelines

Intervention Type PROCEDURE

Treatment as described in the guidelines from the European Resuscitation Council, the Norwegian Resuscitation Council, and other local national guidelines

Interventions

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REBOA

Resuscitative endovascular balloon occlusion of the aorta (REBOA)

Intervention Type PROCEDURE

usual procedure according to guidelines

Treatment as described in the guidelines from the European Resuscitation Council, the Norwegian Resuscitation Council, and other local national guidelines

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* out-of-hospital cardiac arrest
* non-traumatic cardiac arrest
* less than 10 minutes from debut of arrest to start of basic or advanced cardiac life support
* advanced cardiac life support is established and can be continued

Exclusion Criteria

* traumatic cardiac arrest, including strangulation, electrocution and patients rescued from avalanches
* accidental hypothermia with temperature \< 32 0C
* suspected cerebral hemorrhage as etiology of the arrest
* suspected non-traumatic hemorrhage as etiology of the arrest
* pregnancy, obvious or suspected
* patient included to the study site's E-CPR protocol
* other factors as decided by the treatment team (environmental factors, safety factors and others)
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Norwegian Air Ambulance Foundation

OTHER

Sponsor Role collaborator

St. Olavs Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rune Wiseth, MD, PhD

Role: STUDY_DIRECTOR

St Olav&amp;amp;#39;s Hospital

Locations

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Aarhus Base

Aarhus, , Denmark

Site Status

Billund HEMS-base

Billund, , Denmark

Site Status

Ringsted HEMS-base

Ringsted, , Denmark

Site Status

Skive HEMS

Skive, , Denmark

Site Status

Maggiore Hospital

Bologna, , Italy

Site Status

Haukeland University Hospital

Bergen, , Norway

Site Status

Drammen Hospital

Drammen, , Norway

Site Status

Lørenskog HEMS Unit

Oslo, , Norway

Site Status

Rapid response car - 119 Oslo

Oslo, , Norway

Site Status

Stavanger University Hospital

Stavanger, , Norway

Site Status

St Olavs Hospital

Trondheim, , Norway

Site Status

Countries

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Denmark Italy Norway

References

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Brede JR, Lafrenz T, Klepstad P, Skjaerseth EA, Nordseth T, Sovik E, Kruger AJ. Feasibility of Pre-Hospital Resuscitative Endovascular Balloon Occlusion of the Aorta in Non-Traumatic Out-of-Hospital Cardiac Arrest. J Am Heart Assoc. 2019 Nov 19;8(22):e014394. doi: 10.1161/JAHA.119.014394. Epub 2019 Nov 11.

Reference Type BACKGROUND
PMID: 31707942 (View on PubMed)

Brede JR, Skulberg AK, Rehn M, Thorsen K, Klepstad P, Tylleskar I, Farbu B, Dale J, Nordseth T, Wiseth R, Kruger AJ. REBOARREST, resuscitative endovascular balloon occlusion of the aorta in non-traumatic out-of-hospital cardiac arrest: a study protocol for a randomised, parallel group, clinical multicentre trial. Trials. 2021 Jul 31;22(1):511. doi: 10.1186/s13063-021-05477-1.

Reference Type DERIVED
PMID: 34332617 (View on PubMed)

Other Identifiers

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U1111-1253-0322

Identifier Type: REGISTRY

Identifier Source: secondary_id

U1111-1253-0322

Identifier Type: -

Identifier Source: org_study_id

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