PEEP vs. ZEEP in Out-of-Hospital-Cardiac-Arrest
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: PEEP 5 mbar, ZEEP 0 mbar.
- Who it may be relevant to
- Registry conditions: Ventilation Therapy, PEEP, Occult, CPR, Cardiac Arrest (CA). Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Germany
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Peri-Arrest Ventilation With Positive End-Expiratory-Pressure vs. Zero End-Expiratory-Pressure in Out-of-Hospital-Cardiac-Arrest
Overview
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.
Detailed description
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.
Interventions
- Procedure PEEP 5 mbar
Positiv-End-Expiratory Pressure - Procedure ZEEP 0 mbar
Zero-End-Expiratory Pressure
Primary outcome measures
- The return of spontaneous circulation (ROSC) [Time frame: During or after resuscitation]
Secondary outcome measures (6)
- Re-Arrest-Rate [Time frame: Upon hospital admission]
- Death during pre-hospital care phase [Time frame: Upon hospital admission]
- Hospital admission during ongoing resuscitation [Time frame: at hospital admission]
- Hospital admission with spontaneous circulation [Time frame: at hospital admission]
- SpO2 at hospital admission [Time frame: at hospital admission]
- FiO2 at hospital admission [Time frame: at hospital admission]
Eligibility criteria
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)
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Health services research
Study locations
Germany · 3 centers
- Emergency Medical Services — Gütersloh
- JWK Minden — Minden
- Emergency Medical Services — Osnabrück
Publications
- Vaseekaran M, Vollmer T, Kolaparambil Varghese LJ, Zeichen C, Hinkelbein J, Abels R, Strickmann B, Deicke M, Grannemann JJ, Grunzig R, Hoyer A, Persson J, Tiesmeier J, Veit G, Jansen G. Peri-arrest ventilation with positive end-expiratory-pressure vs. zero end-expiratory-pressure in out-of-hospital-cardiac-arrest (PerAVent)-a prospective, cluster-randomized multicenter trial. Trials. 2026 Jan 21;2 PMID 41566395
Identifiers
NCT: NCT06836830 · 2024-1148