CClinicalTrials.gg
RecruitingNCT06207942Updated Apr 23, 2025

Stepcare Extended Follow-up Substudy

An interventional study of Feed back controlled temperature device and High MAP in Cardiac Arrest With Successful Resuscitation, Hypoxia, Brain and Cognitive Impairment, sponsored by Region Skane. Recruiting at 34 sites in 10 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-04-23.

Sponsored by Region Skane · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
600
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

To provide detailed information on long-term outcomes in relation to potential neuroprotection and improvements in recovery for different targets of sedation, temperature, and pressure management in post out of hospital cardiac arrest survivors at 6 and 12 months. In addition, the impact of caring for a post OHCA survivor will be explored.

Read the detailed description

This extended follow-up substudy is incorporated into the multi-center, international, factorial randomized Sedation, Temperature and Pressure after Cardiac Arrest and Resuscitation -STEPCARE trial (Clinical trials identifier:NCT05564754) were out of hospital cardiac arrest participants will be randomized to different targets of sedation, temperature, and MAP management.

Only selected STEPCARE sites will participate in this extended follow-up substudy. At the extended follow up participating sites all out of hospital cardiac arrest participants randomized in the STEPCARE trial, who survive and provide consent, will be eligible to participate in this substudy, with no further inclusion or exclusion criteria.The extended follow-up substudy is estimated to enroll approximately 600 post OHCA survivors. One nominated caregiver per post OHCA survivor will be invited to be included in the study.

Participants will be followed up at 6 and 12 months.

The primary outcome for this extended follow up substudy is cognitive function at 6 months for the out of hospital cardiac arrest survivors andCaregiver burden at 6 months for the caregivers.

02

Conditions studied

  • Cardiac Arrest With Successful Resuscitation
  • Hypoxia, Brain
  • Cognitive Impairment
  • Caregiver Burden
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

All OHCA participants randomized in the STEPCARE trial at the extended follow-up participating sites, who survive and provide consent, with no further inclusion or exclusion criteria.

The inclusion and exclusion criteria for the STEPCARE trial are:

  • Inclusion criteria: out-of-hospital cardiac arrest of non-traumatic origin, minimum of 20 minutes without chest compressions (defined as stable return of spontaneous circulation. ROSC), unconsciousness (defined as not being able to obey verbal commands equal to a FOUR-score motor response of \<4, or being intubated and sedated because of agitation after sustained ROSC, eligible for intensive care without restrictions or limitation, inclusion within 4 hours (240 minutes) of ROSC (or 220 minutes of stable ROSC).
  • Exclusion criteria: on ECMO prior to randomization, pregnancy, suspected or confirmed intracranial hemorrhage, previously randomized in the STEPCARE trial.

For caregivers, the eligibility will be that they live with, or have weekly or more frequent contact (in person or over the telephone) with the post OHCA survivor. Only one nominated caregiver per post OHCA survivor will be able to be included in the study. This would typically be the caregiver that would identify as the primary caregiver of the post OHCA survivor if needed, but may also be another close family member.

04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Factorial assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
600 participants (estimated)

Study arms

  • Active comparator
    Sedation, temperature device and high MAP

    Device: Feed back controlled temperature device · Other: High MAP · Other: Deep sedation

  • Active comparator
    Sedation, no temperature device and high MAP

    Other: High MAP · Other: Deep sedation · Other: Fever control without a device

  • Active comparator
    Sedation, temperature device and low MAP

    Device: Feed back controlled temperature device · Other: Deep sedation · Other: Low MAP

  • Active comparator
    Sedation, no temperature device, and low MAP

    Other: Deep sedation · Other: Fever control without a device · Other: Low MAP

  • Active comparator
    Minimal sedation, temperature device, and high MAP

    Device: Feed back controlled temperature device · Other: High MAP · Other: Minimal sedation

  • Active comparator
    Minimal sedation, no temperature device and high MAP

    Other: High MAP · Other: Fever control without a device · Other: Minimal sedation

  • Active comparator
    Minimal sedation, temperature device and low MAP

    Device: Feed back controlled temperature device · Other: Low MAP · Other: Minimal sedation

  • Active comparator
    Minimal sedation, no temperature device and low MAP

    Other: Fever control without a device · Other: Low MAP · Other: Minimal sedation

Interventions

  • DeviceFeed back controlled temperature device

    If core temperature exceeds 37.7 degrees celsius a feedback controlled-device will be used at set to 37.5 degrees celsius

  • OtherHigh MAP

    A mean arterial blood pressure (MAP) of \>85mmHg will be used. Vasopressors will be titrated to this target during 36 hours

  • OtherDeep sedation

    Deep sedation for at least 36 hours

  • OtherFever control without a device

    Management of fever in the intensive care unit without a device

  • OtherLow MAP

    A mean arterial blood pressure (MAP) of \>65mmHG will be used. Vasopressors will be titrated to this target during 36 hours

  • OtherMinimal sedation

    A strategy of minimal sedation in the intensive care unit, used only as needed to facilitate transport, imaging and invasive procedures

05

What researchers measure

Primary outcomes

  1. Montreal Cognitive Assessment (MoCA)

    Cognitive function for out of hospital cardiac arrest survivors. Score range. Higher scores=better cognition

    Time frame: 6 months

  2. Zarit Burden Interview (ZBI)

    Caregiver burden for caregivers to out of hospital cardiac arrest survivors. Score range 0-88. Higher scores= worse indicating more caregiver burden

    Time frame: 6 months

Other outcomes

  1. Symbol Digit Modalities Test (SDMT)

    Processing speed. For out of hospital cardiac arrest survivors. Scores presented as age and education adjusted z-scores. Higher scores=better

    Time frame: 6 and 12 months

  2. Hospital Anxiety and Depression Scale (HADS)

    Symptoms of anxiety and depression. For both out of hospital cardiac arrest survivors and caregivers. Score range 0-21 for anxiety and depression respectively. Higher scores=worse and incerased symptoms of anxiety and depression

    Time frame: 6 and 12 months

  3. Post Posttraumatic Stress Disorders Checklist updated for DSM-5 (PCL-5)

    Symptoms of posttraumatic stress. For both out of hospital cardiac arrest survivors and caregivers. Score range 0-80. Higher scores=worse indicating increased symptoms of PTSD

    Time frame: 6 and 12 months

  4. Modified Fatigue Impact Scale (MFIS)

    Impact of fatigue. For out of hospital cardiac arrest survivors. Score range 0-84. Higher scores= worse indicating more problems with impact of fatigue

    Time frame: 6 and 12 months

  5. modified Rankin Scale (mRS)

    Functional outcome. For out of hospital cardiac arrest survivors. Score range 0-6. Higher scores= worse indicating a poorer functional outcome

    Time frame: 12 months

  6. World Health Organization Disability Assessment (WHODAS) 2.0

    Disability. For both out of hospital cardiac arrest survivors and caregivers. 36 item version score range 0-100. 12 item version score range 0-48. Higher scores=worse indicating more disability

    Time frame: 6 and 12 months

  7. Return to work

    Questions about work prior to cardiac arrest and at time of follow up. For both out of hospital cardiac arrest survivors and caregivers. Categorical item

    Time frame: 6 and 12 months

  8. EuroQol health survey 5 dimensions 5 levels response version (EQ-5D-5L)

    Health related quality of life. For both out of hospital cardiac arrest survivors and caregivers. For EQ dimensions score range 1-5 and higher scores=worse indicating more health problems. For EQ VAS score range is 0-100 with higher scores= better and representing higher satisfaction with overall health

    Time frame: 12 months for out of hospital cardiac arrest survivors. 6 and 12 months for caregiver

  9. Life satisfaction visual analogue scale from the World Value Survey

    Life satisfaction. For both out of hospital cardiac arrest survivors and caregivers. Score range 1-10. Higher scores=better indicating better life satisfaction

    Time frame: 6 and 12 months

  10. Timed Stands Test (TST)

    Lower extremity strength. For out of hospital cardiac arrest survivors. Raw score adjusted for gender and age and categorized as normal, problems or unable.

    Time frame: 6 and 12 months

  11. Jamar hand grip dynamometer

    Upper extremity strength. For out of hospital cardiac arrest survivors. Raw scores age and gender adjusted and categorized as normal, problems or unable.

    Time frame: 6 and 12 months

06

Study locations

34 of 34 sites recruiting
  • Princess Alexandra Hospital
    Brisbane, Australia
    • James Walsham · Contact
    Recruiting
  • The Sutherland Hospital
    Caringbah, Australia
    • Frances Bass · Contact
    Recruiting
  • The Prince Charles Hospital
    Chermside, Australia
    • Frances Bass · Contact
    Recruiting
  • Nepean hospital
    Kingswood, Australia
    • Ian Seppelt, Dr · Contact
    Recruiting
  • St George hospital
    Kogarah, Australia
    Recruiting
  • Liverpool hospital
    Liverpool, Australia
    • Anthony Stewart, Dr · Contact
    Recruiting
  • Austin hospital
    Melbourne, Australia
    Recruiting
  • Royal North Shore Hospital
    Sydney, Australia
    • Frances Bass · Contact
    Recruiting
  • Ziekenhuis Oost Limburg
    Genk, Belgium
    Recruiting
  • Ghent university hospital
    Ghent, Belgium
    • Patrick Druwve · Contact
    Recruiting
  • Helsinki Helsingfors university central hospital
    Helsinki, Finland
    • Marjaana Tiainen · Contact
    Recruiting
  • Jorvi hospital
    Jorvi, Finland
    Recruiting
  • Tampere university hospital
    Tampere, Finland
    • Joonas Tirkkonen · Contact
    Recruiting
  • Charite university hospital
    Berlin, Germany
    • Christoph Leithner · Contact
    Recruiting
  • Universitäres Herzzentrum Lübeck Universitätsklinikum Schleswig-Holstein
    Lübeck, Germany
    • Tobias Graf · Contact
    Recruiting
  • Tubingen university hospital
    Tubingen, Germany
    Recruiting
  • Centre Hospitalier de Luxembourg
    Luxembourg, Luxembourg
    • Pascal Stammet, MD, PhD · Contact
    Recruiting
  • Auckland city hospital
    Auckland, New Zealand
    Recruiting
  • Middlemore hospital
    Auckland, New Zealand
    • Paul Young · Contact
    Recruiting
  • Christchurch hospital
    Christchurch, New Zealand
    • Paul Young · Contact
    Recruiting
  • Wellington hospital
    Wellington, New Zealand
    • Paul Young · Contact
    Recruiting
  • Sorlandet hospital
    Arendal, Norway
    Recruiting
  • Oslo university hospital Rikshospitalet
    Oslo, Norway
    • Louis Romundstad · Contact
    Recruiting
  • Sahlgrenska university hospital
    Gothenburg, Sweden
    • Jonathan Oras · Contact
    • Andreas Lundin · Contact
    Recruiting
  • Hallands hospital
    Halland, Sweden
    • Johan Unden, MD PhD · Contact
    Recruiting
  • Helsingborg hospital
    Helsingborg, Sweden
    • Jesper Johnsson, MD, PhD · Contact
    Recruiting
  • Skåne university hospital
    Lund, Sweden
    • Anna Lybeck, MD, PhD · Contact
    Recruiting
  • Skåne university hopsital
    Malmö, Sweden
    • Joachim During, MD, PhD · Contact
    Recruiting
  • Bern university hospital
    Bern, Switzerland
    • Manuela Itens · Contact
    Recruiting
  • Kantonsspital St. Gallen
    Saint Gallen, Switzerland
    • Claudia Schrag · Contact
    Recruiting
  • The Essex Cardiothoracic Centre
    Basildon, United Kingdom
    • Thomas Keeble · Contact
    Recruiting
  • Bristol Royal Infirmary
    Bristol, United Kingdom
    • Matthew Thomas · Contact
    Recruiting
  • University hospital of Wales
    Cardiff, United Kingdom
    • Matt Wise · Contact
    Recruiting
  • St Bartholomew's hospital
    London, United Kingdom
    • Nikolaos Gorgoraptis · Contact
    Recruiting
07

References and documents

Individual participant data

Plan to share: Undecided — Upon resonable request following publication

08

Registry details

Key details

Study ID
NCT06207942
Lead sponsor
Region Skane
Collaborators
Lund University, The George Institute for Global Health, Australia, Copenhagen Trial Unit, Center for Clinical Intervention Research, Helsinki University Central Hospital
Responsible party
Sponsor
First posted
Jan 17, 2024
Start date
Aug 1, 2023
Primary completion
Jan 2027 (estimated)
Completion
Jul 31, 2027 (estimated)
Last update
Apr 23, 2025

Study contacts

Gisela Lilja, PhD
Contact
gisela.lilja@med.lu.se
+4646176393

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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