Understanding post‑cardiac arrest brain injury through spinal fluid molecular analysis

Identification of Novel Molecular Pathophysiological Mechanisms of Secondary Brain Injury in Post-cardiac Arrest Syndrome Patients Using Cerebrospinal Fluid Multi-omics Analysis

This project will test whether detailed molecular analysis of spinal fluid from people who had a cardiac arrest can reveal targets for new treatments.

Quick facts

• Study type: Observational
• Enrollment: 60 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Chungnam National University Hospital (Academic / other)
• Locations: 1 site (Daejeon, Jung-gu)
• Trial ID: NCT07481396 on ClinicalTrials.gov

What this trial studies

The protocol collects cerebrospinal fluid (CSF) from patients receiving post‑resuscitation care after out‑of‑hospital cardiac arrest and performs multi‑omics profiling across the genome, transcriptome, proteome, and metabolome. Identified molecular pathways will be compared with drug databases and used in computational modeling to nominate existing compounds or design new candidates. Promising candidates will be synthesized and prioritized to provide rationale for future preclinical experiments in cardiac arrest animal models. Patients with contraindications to lumbar puncture, evidence of cerebral edema, or those treated with ECMO are excluded from sampling.

Who should consider this trial

Good fit: Ideal candidates are patients receiving post‑resuscitation care after out‑of‑hospital cardiac arrest who can safely undergo lumbar puncture without bleeding, infection, or other contraindications.

Not a fit: Patients with cerebral edema on immediate post‑resuscitation CT, those on ECMO, or those with contraindications to lumbar puncture are unlikely to participate or benefit from the CSF‑based findings.

Why it matters

Potential benefit: If successful, the work could identify molecular targets in CSF that lead to new therapies to reduce secondary brain injury after cardiac arrest.

How similar studies have performed: Related proteomic and metabolomic CSF studies in brain injury have found candidate biomarkers, but multi‑omics approaches linking findings to drug candidates remain largely exploratory and not yet translated to therapies.

Eligibility criteria

Inclusion Criteria:

* Patients receiving post-resuscitation care after out-of-hospital cardiac arrest for secondary brain injury treatment.
* Patients without contraindications for lumbar puncture catheter insertion for cerebrospinal fluid (CSF) collection. This includes the absence of:
* Uncontrolled diabetes.Coagulation disorders.
* Thrombocytopenia (platelet count $\< 100,000).
* A history of cirrhosis diagnosis.
* Current receipt of low molecular weight heparin.
* Current use of platelet inhibitors.
* A history of posterior spinal fusion that may interfere with catheter insertion.
* Local skin infection or rash at the puncture site.
* Signs of systemic infection or sepsis.
* A history of lumbar puncture within the past 6 hours.

Exclusion Criteria:

* Cerebral Edema: Patients with evidence of cerebral edema on a brain computed tomography (CT) scan performed immediately after spontaneous circulation recovery.
* Patients who underwent extracorporeal membrane oxygenation (ECMO).
* Patients who could not maintain integrated therapy for more than 24 hours after cardiac arrest.
* Patients with a history of acute or chronic brain disease.

Where this trial is running

Daejeon, Jung-gu

• Chungnam National University Hospital — Daejeon, Jung-gu, South Korea (Recruiting)

Study contacts

• Study coordinator: Changshin Kang, MD. PhD

Conditions Cardiac Arrest; Cerebrospinal Fluid; Multiomics; Hypoxic-Ischemic Brain Injury