Prehospital Resuscitation Intranasal Cooling Effectiveness Survival Study 2

NCT ID: NCT06025123

Last Updated: 2025-09-25

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

RECRUITING

Clinical Phase

NA

Total Enrollment

1022 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-27

Study Completion Date

2028-05-31

Brief Summary

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The aim of this clinical trial is to study the impact of ultra-early transnasal evaporative cooling after cardiac arrest and subsequent hypothermia at hospital, on survival with complete neurologic recovery, compared to currently recommended normothermia. The study population will consist of patients 18-79 years old, with out-of-hospital cardiac arrest with initial shockable rhythm.

The main research question it aims to answer is whether there is a difference in survival with complete neurologic recovery at 90 days after cardiac arrest between the group of patients that received ultra-early cooling, compared to the group that was treated with normothermia.

Participants will be randomized to two groups. One group (the intervention group) will receive ultra-early trans-nasal evaporative cooling initiated by EMS personnel at the scene of the cardiac arrest, and subsequent systemic hypothermia for 24 hours at hospital arrival. The other group (the control group), will receive standard of care (advanced cardiac life support and normal body temperature (normothermia)).

Detailed Description

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Conditions

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Out-Of-Hospital Cardiac Arrest Hypothermia Ventricular Fibrillation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients will be randomized by EMS personnel at the scene of cardiac arrest to either a) intervention: early transnasal evaporative cooling initiated within 20 minutes from EMS arrival, and subsequent systemic hypothermia at 33°C for 24 h and fever control for 72 h in the ICU, or b) control: standard ACLS (advanced cardiac life support) and fever control (normothermia) for 72 h in the ICU.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Patients in the intervention group will be treated with hypothermia, which makes blinding for care provider and next of kin difficult in the intervention phase (first 36 h). Participants will be informed of which group the were assigned to if they regained consciousness. The study personnel assessing neurologic outcome at discharge and at 90 days will be blinded for which study group the participant belongs to. In addition, the physician performing the prognostication at 72 hours from cardiac arrest will be a neurologist, intensivist or other specialist experienced and will be blinded for group allocation, but not for relevant clinical data.

Study Groups

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Early transnasal evaporative cooling with the RhinoChill device

Early transnasal evaporative cooling initiated during ACLS at the scene of the cardiac arrest within 20 minutes from EMS arrival and subsequent hypothermia at 33ºC for 24 hours and fever control for 72 hours at the ICU

Group Type EXPERIMENTAL

Early transnasal evaporative cooling with the RhinoChill device

Intervention Type DEVICE

Early prehospital transnasal evaporative cooling followed by systemic hypothermia to 33 degrees Celsius for 24 hours and fever control for 72 hours

Standard of care

Standard advanced cardiac life support, subsequent fever control (Normothermia) for 72 hours at ICU

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Early transnasal evaporative cooling with the RhinoChill device

Early prehospital transnasal evaporative cooling followed by systemic hypothermia to 33 degrees Celsius for 24 hours and fever control for 72 hours

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Adult out-of-hospital cardiac arrest patients with initial shockable rhythm
2. Unconsciousness defined as Glasgow Coma Scale \< 8
3. Inclusion within 20 minutes from EMS arrival

Exclusion Criteria

Patients are not eligible if they meet one or more of the following criteria:

1. Age ≥ 80 years
2. Obvious non-cardiac causes to cardiac arrest
3. Obvious already hypothermic
4. Obvious barrier to placing intra nasal catheters
5. Have a known Do Not Attempt to Resuscitate (DNAR) order or other limitations in care
6. Have a known terminal disease
7. Known or clinically apparent pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Karolinska Institutet

OTHER

Sponsor Role lead

Responsible Party

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Per Nordberg

Senior consultant in cardiology and intensive care, Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Per Nordberg, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Locations

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University Hospital Vienna

Vienna, , Austria

Site Status NOT_YET_RECRUITING

CHU Saint-Pierre

Brussels, , Belgium

Site Status RECRUITING

Erasme University Hospital

Brussels, , Belgium

Site Status RECRUITING

Europe Hospitals St Elizabeth

Brussels, , Belgium

Site Status RECRUITING

University Hospital Freiburg

Freiburg im Breisgau, , Germany

Site Status RECRUITING

Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Milan, , Italy

Site Status NOT_YET_RECRUITING

Ljubljana University Medical Centre

Ljubljana, , Slovenia

Site Status RECRUITING

Hospital Universitario La Paz

Madrid, , Spain

Site Status RECRUITING

San Carlos Clinical Hospital

Madrid, , Spain

Site Status RECRUITING

Karolinska University Hospital

Stockholm, , Sweden

Site Status RECRUITING

Södersjukhuset

Stockholm, , Sweden

Site Status RECRUITING

Countries

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Austria Belgium Germany Italy Slovenia Spain Sweden

Central Contacts

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Per Nordberg, MD, PhD

Role: CONTACT

+46702802579

Emelie Dillenbeck, MD

Role: CONTACT

+46736484567

Facility Contacts

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Michael Holzer, MD, PhD

Role: primary

Marie-Astrid de Villenfagne, PhD

Role: primary

Fabio S Taccone, MD, PhD

Role: primary

Michael Vandoorslaert, PhD

Role: primary

Hans-Jörg Busch, MD, PhD

Role: primary

Giuseppe Ristagno, Prof

Role: primary

Peter Radsel, MD

Role: primary

Sandra O Rosillo Rodríguez, PhD

Role: primary

Ervigio Corral Torres

Role: backup

Miguel Sanchez, PhD

Role: primary

Juan Carlos Martín Benítez, PhD

Role: backup

Per Nordberg, PhD

Role: primary

Emelie Dillenbeck, MD

Role: primary

Akil Awad, PhD

Role: backup

References

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Dillenbeck E, Hollenberg J, Holzer M, Busch HJ, Nichol G, Radsel P, Belohlavec J, Torres EC, Lopez-de-Sa E, Rosell F, Ristagno G, Forsberg S, Annoni F, Svensson L, Jonsson M, Backstrom D, Gellerfors M, Awad A, Taccone FS, Nordberg P. The design of the PRINCESS 2 trial: A randomized trial to study the impact of ultrafast hypothermia on complete neurologic recovery after out-of-hospital cardiac arrest with initial shockable rhythm. Am Heart J. 2024 May;271:97-108. doi: 10.1016/j.ahj.2024.02.020. Epub 2024 Feb 28.

Reference Type DERIVED
PMID: 38417773 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2022-02446-01

Identifier Type: -

Identifier Source: org_study_id

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