An observational study in Circulatory Shock, Hemodynamic Instability and Hypotension, sponsored by Region Stockholm. Recruiting at 1 site in Sweden. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-18.
Sponsored by Region Stockholm · Observational
This prospective multicenter observational study aims to investigate the relationship between palpable peripheral pulses and simultaneously measured arterial blood pressure in adult patients with circulatory shock or impending circulatory failure. Peripheral pulse palpation is routinely used in emergency medicine, trauma care, critical care, and cardiopulmonary resuscitation as a rapid clinical assessment of circulation. However, the association between palpable pulses and actual arterial blood pressure remains poorly validated.
Patients treated in emergency departments, intensive care units, operating rooms, and other acute care settings will undergo routine pulse palpation at predefined anatomical locations including carotid, femoral, and radial arteries. Simultaneously measured non-invasive and/or invasive arterial blood pressure values will be recorded from routine clinical monitoring systems. Additional clinical variables relevant to circulatory status will also be collected.
The study seeks to define blood pressure thresholds associated with pulse palpability and evaluate the agreement between invasive and non-invasive blood pressure measurements in patients with circulatory shock.
The presence or absence of palpable peripheral pulses is widely used as a rapid bedside indicator of circulatory status during trauma care, emergency medicine, intensive care, and cardiopulmonary resuscitation. Advanced Trauma Life Support (ATLS) teaching traditionally assumes that palpable pulses at different anatomical sites correspond to specific systolic blood pressure thresholds. However, these assumptions are based on limited evidence from small observational studies.
This international multicenter prospective observational cohort study aims to investigate the relationship between palpable carotid, femoral, and radial pulses and simultaneously measured arterial blood pressure in adult patients with circulatory shock or impending circulatory failure.
Patients receiving routine hemodynamic monitoring with non-invasive blood pressure (NIBP) and/or invasive arterial blood pressure (IBP) monitoring will be included. Pulse palpation will be performed during routine clinical care without altering treatment or management.
The primary objective is to determine the association between pulse palpability and measured systolic blood pressure. Secondary objectives include identifying blood pressure thresholds associated with pulse palpability, evaluating agreement between invasive and non-invasive blood pressure measurements, and assessing whether patient factors such as vascular disease or vasoactive medication use influence pulse palpability.
487 studies on the registry are indexed under Shock; 107 are open to participants now.
This study's planned enrollment of 5,000 is above the median of 100 across 247 observational studies indexed under Shock.
Browse Shock studies →Region Stockholm is the lead sponsor of 121 studies on the registry; 69 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Adult patients with circulatory shock or impending circulatory failure treated in emergency departments, intensive care units, operating rooms, trauma centers, and other acute care settings.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Adult patients with clinical signs of circulatory shock or impending circulatory failure undergoing routine hemodynamic monitoring with non-invasive and/or invasive arterial blood pressure measurement during standard clinical care.
Procedure: Peripheral Pulse Palpation
Manual palpation of carotid, femoral, and radial pulses performed during routine clinical care in patients with circulatory instability. Simultaneous arterial blood pressure measurements are recorded from standard monitoring systems. No study-specific treatment or intervention is administered.
Association between palpable pulses and systolic arterial blood pressure
Relationship between palpable carotid, femoral, and radial pulses and simultaneously measured systolic arterial blood pressure.
Time frame: During episodes of circulatory instability, up to 24 hours after inclusion
Mean arterial pressure associated with pulse palpability
Relationship between pulse palpability and mean arterial pressure (MAP).
Time frame: During episodes of circulatory instability, up to 24 hours after inclusion
Agreement between non-invasive and invasive blood pressure measurements
Agreement between oscillometric non-invasive blood pressure and invasive arterial blood pressure measurements.
Time frame: During episodes of circulatory instability, up to 24 hours after inclusion
Effect of vascular disease and vasoactive medication on pulse palpability
Influence of peripheral vascular disease, atherosclerosis, age, and vasoactive medications on pulse palpability.
Time frame: During hospital admission, up to 30 days
Plan to share: Undecided — Data sharing plans are currently undecided due to ongoing considerations regarding ethical approvals, multicenter collaboration agreements, and data protection regulations.
Started Jun 2026 (actual). Primary completion is estimated for Jun 2031, 60 months after the start.
Of 120 non-industry observational studies under Shock, half reached primary completion within 26 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 52. This study's planned 60 months is above that.
Counting every sponsor, half of 127 studies reached it within 26 months; a quarter within 12 and three quarters within 52.
How these figures are worked out, and which studies are left out of them.
Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.
Contact study teamGet an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.