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NCT Number: NCT06836830

PEEP vs. ZEEP in Out-of-Hospital-Cardiac-Arrest

Out-of-hospital cardiac arrest (OHCA) remains a major cause of mortality, with low survival probabilities to hospital discharge. Despite the frequent use of airway management and mechanical ventilation during resuscitation, there is limited evidence regarding the optimal ventilation strategy to improve oxygen delivery and patient outcomes. The present study aims to investigate the effects of positive-end-expiratory-pressure (PEEP) set at 5 mbar compared to zero-end-expiratory-pressure (ZEEP) on the return of spontaneous-circulation (ROSC) in adult patients with OHCA.

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Key information

Conditions

Ventilation Therapy CPR Cardiac Arrest (CA) Cardiovascular Diseases Heart Arrest Heart Diseases PEEP, Occult Pathologic Processes Pathological Conditions, Signs and Symptoms Positive-Pressure Respiration, Intrinsic Respiration Disorders Respiratory Aspiration Respiratory Insufficiency Respiratory Tract Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Emergency Medical Services, Gütersloh, North Rhine-Westphalia, Germany

Loading trial locations.

About this study

This is a prospective, multicenter, cluster-randomized controlled trial conducted across emergency medical services (EMS) in the regions of Guetersloh, Minden-Luebbecke and Osnabrueck. Adult patients (>= 18 years) with OHCA who are undergoing mechanical ventilation through an airway device will be enrolled. The clusters (regional district) will be randomized into two groups: one group will receive ventilation with PEEP set at 5 mbar (intervention group), while the other group will receive ventilation with ZEEP (control group). The study's primary endpoint is the rate of ROSC. Secondary endpoints include rate of re-arrest, death during pre-hospital care phase, hospital admission during ongoing resuscitation, hospital admission with spontaneous circulation, peripheral oxygen saturation and end tidal CO2 at hospital admission.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adults >= 18 years
  • non-traumatic OHCA
  • mechanical ventilation via airway device

Exclusion criteria

  • Patients < 18 years,
  • traumatic cause of OHCA,
  • no cardiac arrest, withholding of resuscitation (e.g. Do-Not-Resuscitate orders)

Treatment and study plan

PEEP 5 mbar

Procedure

Positiv-End-Expiratory Pressure

ZEEP 0 mbar

Procedure

Zero-End-Expiratory Pressure

Primary outcomes

  1. The return of spontaneous circulation (ROSC)

    Time frame: During or after resuscitation

    The primary outcome is the ROSC, defined according to the Utstein template by the presence of a palpable pulse during or after resuscitation. This will be measured as a binary outcome (palpable pulse, yes or no).

Secondary outcomes

  1. Re-Arrest-Rate

    Time frame: Upon hospital admission

    Any need for chest compressions after ROSC (yes vs. no)

  2. Death during pre-hospital care phase

    Time frame: Upon hospital admission

    Any death during pre-hospital care phase (yes vs. no)

  3. Hospital admission during ongoing resuscitation

    Time frame: at hospital admission

    Need for chest-compressions at hospital admission (yes vs. no)

  4. Hospital admission with spontaneous circulation

    Time frame: at hospital admission

    Hospital admission with spontaneous circulation without need for chest compressions (yes vs. no)

  5. SpO2 at hospital admission

    Time frame: at hospital admission

    SpO2 at hospital admission (%)

  6. FiO2 at hospital admission

    Time frame: at hospital admission

    FiO2 at hospital admission (%)

Study contacts

Contact information is provided by the study sponsor or research team.

Gerrit Jansen, PD Dr. med.

CONTACT

[email protected]

+49 571-790-54401

Jochen Hinkelbein, Prof. Dr. med.

CONTACT

[email protected]

+49 571-790-54401

Sponsors and collaborators

Lead sponsor

Muehlenkreiskliniken, MKK

Other

Registry information

Official study title

Peri-Arrest Ventilation With Positive End-Expiratory-Pressure vs. Zero End-Expiratory-Pressure in Out-of-Hospital-Cardiac-Arrest

Acronym: PerAVent

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Feb 20, 2025
Registry last updated
Aug 6, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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