Effects of mean arterial pressure on outcomes after out-of-hospital cardiac arrest
Official title: Mean Arterial Pressure After Out-of-hospital Cardiac Arrest: the METAPHORE Randomized Trial
Run by Centre Hospitalier le Mans · NCT05486884 · Data updated 2026-11-12
This study tests if keeping blood pressure at a higher level after a cardiac arrest can help patients recover better and survive longer.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 1380 (estimated) |
| Sponsor | Centre Hospitalier le Mans Academic / other |
| Locations | 31 sites (Montpellier, Sarthe and 30 other locations) |
| Status | Recruiting |
| Started | September 28, 2024 |
| Main results expected | March 28, 2028 |
| Study ends | March 28, 2028 |
| Registry record updated | September 9, 2026 |
| Trial ID | NCT05486884 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates include adults who have been admitted to the ICU following an out-of-hospital cardiac arrest with sustained ROSC and are under invasive mechanical ventilation for coma.
✕Probably not a fit
Patients under 18 years old, those with in-hospital cardiac arrest, or those with specific contraindications such as severe hemorrhage or acute brain disease may not benefit from this study.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This clinical trial investigates the impact of maintaining different levels of mean arterial pressure (MAP) on patients who have experienced out-of-hospital cardiac arrest. The study aims to determine whether targeting a higher MAP of 90 mmHg, compared to the standard 65 mmHg, can improve neurological outcomes and overall survival rates. Patients will be monitored in the intensive care unit (ICU) after achieving return of spontaneous circulation (ROSC) and will be assessed for their neurological status and recovery. The trial seeks to clarify the optimal MAP threshold for post-cardiac arrest care.
Why it matters
Potential benefit: If successful, this study could lead to improved survival and neurological outcomes for patients who suffer from out-of-hospital cardiac arrest.
How similar studies have gone: Previous observational studies have shown a correlation between MAP and neurological prognosis, indicating that this approach has some supportive evidence, although the specific higher MAP target is still being evaluated.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Admission to ICU following an out-of-hospital cardiac arrest with an initially shockable or non-shockable rhythm ; * Sustained ROSC defined as 20 minutes with signs of circulation without the need for chest compressions; * Under invasive mechanical ventilation for coma, defined as a Glasgow score ≤ 8/15; * Consent from a relative or of a procedure for emergency inclusion. Exclusion Criteria: * Age \< 18 years ; * In-hospital cardiac arrest (first cardiac arrest); * Unwitnessed CA with initial rhythm of asystole * Delay between ROSC and attempting randomisation \> 6 hours ; * Cardiac arrest in a context of multiple trauma ; * Cardiac arrest in a context of hemorrhagic shock or severe hemorrhage necessitating hemostasis (surgery or radiological or endoscopic hemostasis) ; * Cardiac arrest secondary to an acute brain disease (ischemic or hemorrhagic stroke, subarachnoid hemorrhage, severe traumatic brain injury) ; * Refractory shock : Defined as a MAP \< 65 mmHg for more than one hour on norepinephrine or epinephrine at a dose \> 1 µg/kg/min despite adequate fluid resuscitation ; * Extracorporeal circulatory support prior to inclusion; * Known allergy to norepinephrine or to any of its excipients; * Decision to limit care before inclusion ; * Modified Rankin score of 4 or 5 before cardiac arrest ; * Inclusion in another interventional study in which the principal endpoint is neurological prognosis ; * Pregnancy or breast feeding ; * Adult patient deprived of freedom or under legal protection (patients under guardianship or curatorship) (article L1121-6 of the French Health Code) ; * Non-French speaking; * Patient already included in this trial ; * Absence of social security cover.
Where it's running
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CHU Brest - Hôpital de La Cavale Blanche
Brest, France Recruiting -
CH Brive
Brive-la-Gaillarde, France Recruiting -
CHU Caen
Caen, France Recruiting -
CH Cholet
Cholet, France Recruiting -
CH Dieppe
Dieppe, France Recruiting -
CHU Dijon - Hôpital F. Mitterrand
Dijon, France Recruiting
Show 25 more locations
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CHD Vendée
La Roche-sur-Yon, France Recruiting -
CH Versailles
Le Chesnay, France Recruiting -
Centre Hospitalier Du Mans
Le Mans, France Recruiting -
CH Dr Schaffner
Lens, France Recruiting -
CHU Lille
Lille, France Recruiting -
CHU Limoges
Limoges, France Recruiting -
APHM - Hôpital de la Timone
Marseille, France Recruiting -
Hôpital Jacques Cartier
Massy, France Recruiting -
CHU Nantes
Nantes, France Recruiting -
CHU Nice - Hôpital Pasteur
Nice, France Recruiting -
CHU Nice - Hôpital Archet
Nice, France Recruiting -
CHU Nîmes
Nîmes, France Recruiting -
CHR Orléans
Orléans, France Recruiting -
Hôpital Cochin
Paris, France Recruiting -
APHP - Hôpital Européen Georges Pompidou (HEGP)
Paris, France Recruiting -
CHU Poitiers
Poitiers, France Recruiting -
CHU Rennes
Rennes, France Recruiting -
Centre Cardiologique du Nord
Saint-Denis, France Recruiting -
Centre hospitalier Saint Nazaire
Saint-Nazaire, France Recruiting -
CHRU Strasbourg - Nouvel Hôpital Civil
Strasbourg, France Recruiting -
CHRU Tours - Hôpital Bretonneau
Tours, France Recruiting -
CH Bretagne Atlantique
Vannes, France Recruiting -
Hopital Lapeyronie
Montpellier, Sarthe, France Not yet recruiting -
Hopital de Cannes - Simone Veil
Cannes, France Not yet recruiting -
Groupe Hospitalier Pitié-Salpêtriere Charles Foix
Paris, France Not yet recruiting
Study contacts
- Study coordinator: Christelle JADEAU
- Email: cjadeau@ch-lemans.fr
- Phone: +33244710781
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-
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-
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-
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-
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This study will see if how pain is measured and treated in adults brought back after out-of-hospital cardiac arrest relates to delirium, ICU resource use, and longer-term recovery.
-
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This project tests whether the Airway Opening Index (AOI) measured from capnograms during CPR in adults with out-of-hospital cardiac arrest is common and linked to return of spontaneous circulation.
-
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.