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NCT Number: NCT06460519

The Prevalence of the Aortic to Radial Pressure Gradient in States of Shock, Outside the Context of Cardiac Surgery, a Prospective Study

First described in cardiac surgery, the aortic to radial pressure gradient (ATRAP) is the cause of an underestimation of the aortic pressure with a measure assumed with a radial catheter, and he can concert 1 of 3rd patients. The risks factor well known are small height, previous hypertension, long and difficult surgery, radial artery diameter less than 1.8mm.

The ATRAP definition is a pressure difference between radial and femoral (same of the aortic pressure) pressure of 25mmHg on the systolic pressure, or a pressure difference on the mean pressure of 10mmHg, both measures realised by arterial canulation, and with a duration superior than 5 minutes.

If this gradient appears in pathophysiological specifics situations, there is a risk of inappropriate administration of vasopressors, with more hospitalisation days, more side effect of vasopressors like an augmentation of myocardial work.

The ATRAP is documented in septic shock with a prevalence between 21% and 27%. The ATRAP can appear in shocks, moreover with doses of equivalent norepinephrine of 0.5 µg/kg/min who is use for the definition of refractive shock, the difference between the two pressure is higher if the dose of equivalent norepinephrine is higher than 1µg/kg/min. But the prevalence and risks factors are barely unknowns in this situation.

Most of the time, a radial arterial catheter is used for hemodynamic monitoring for his simplicity of utilisation and the lows complications associated. Some medical teams in cardiac surgeries, or in intensive care unit (ICU) for the management of shocks used often radial and femoral arterial catheter. It seems there is no at risk for the utilisation of a radial and femoral arterial canulation.

Out of the situation of cardiac surgery, there is a lack of information of the ATRAP, the objective of the study is to evaluate the prevalence of the ATRAP in shock, out of the situation of cardiac surgery.

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Key information

Conditions

Shock Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

18 year–99 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Département d'anesthésie Réanimation Hôpital Cardiologique Louis Pradel/Groupement Hospitalier Est, Bron, France

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

age superior or equal 18 years
Vasopressors support superior or equal 0.5 µg/kg/min of equivalent norepinephrine
Invasive monitoring of blood pressure with a radial arterial catheter and a femoral arterial catheter decided by de physician
Beginning of the shock less than 48 hours.
Consent

Exclusion criteria

perioperative of cardiac surgery (between the beginning of the surgery and 7 days after)
pregnant woman or breast-feeding
Major person under protection
Person with privation of liberty by a justice decision, or an administrative decision

Treatment and study plan

Non-invasive blood pressure measurements

Other

Non-invasive blood pressure measurements to the tension cuff three times in a row on each side (right arm and left arm)

Primary outcomes

Prevalence (percentage) of ATRAP is determined by the ratio of patients with ATRAP to total. ATRAP is defined by a 25mmHg systolic or 10mmHg mean pressure difference between radial and femoral arterial pressures during more than 5 minutes.

Time frame: The primary outcome will be measure at the inclusion of the patient when the femoral arterial catheter will be in place.

The prevalence of the ATRAP will be show in percentage (%), with his confidence interval at 95%.

Study contacts

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

Martin Ruste, Dr

CONTACT

[email protected]

0472118956 ext. +33

Matthias Jacquet-lagreze, Dr

CONTACT

[email protected]

0783426888 ext. +33

Sponsors and collaborators

Lead sponsor

Hospices Civils de Lyon

Other

Registry information

Official study title

Prevalence of the Aortic to Radial Pressure Gradient in States of Shock

Acronym: PARECHOC

Important dates

Study start: 2024
Primary completion: 2027
Study completion: 2027
First posted: Jun 14, 2024
Registry last updated: Apr 17, 2026

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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