Post-Cardiac Arrest SyndromeCOMPACTNCT07829887
Cerebral Oximetry in Management of Post Cardiac Arrest
A study testing Cerebral oximetry-guided treatment in people with Post-Cardiac Arrest Syndrome and Post Cardiac Arrest Brain Injury, run by University of Calgary at 1 site in Canada.
Trial summary
Resuscitation from a cardiac arrest is a common reason for admission to an intensive care unit (ICU). Because the brain is highly vulnerable to oxygen deprivation, severe brain damage often occurs during a cardiac arrest. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Post-Cardiac Arrest Syndrome, Post Cardiac Arrest Brain Injury, Hypoxic-Ischemic Brain Injury
- What is being tested?
- Cerebral oximetry-guided treatment
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 siteCanada
- Study dates
- 10 Oct 2025to May 2027
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Age >= 18 years
- Cardiac arrest (in- or out-of-hospital) lasting >= 5 minutes
- Glasgow Coma Scale score <= 8 and motor score <= 5
Who cannot join
- Cardiac arrest cause was any form of brain injury
- Cannot be enrolled within 6 hours
- Unsupportable physiology
- CT scan (not mandated) showing diffuse loss of grey-white differentiation
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Canada1 site, 1 recruiting
- Recruiting
Foothills Medical Center
Calgary, Alberta, T3Z 3L7
Andreas Kramer, MD MSc FRCPC, 4034666327, andreas.kramer@albertahealthservices.ca
Ish Bains, PhD, 403-944-0740, ish.bains@albertahealthservices.ca
About this study
Official title: Cerebral Oximetry in Management of Post Cardiac Arrest (COMPACT): A Pilot Randomized Controlled Trial
Resuscitation from a cardiac arrest is a common reason for admission to an intensive care unit (ICU).
Because the brain is highly vulnerable to oxygen deprivation, severe brain damage often occurs during a cardiac arrest. Even when the heart has been restarted, there may continue to be reduced blood flow and oxygen delivery to the brain for many hours. ICU professionals generally do not use any tools to detect low oxygen delivery to the brain.
Read more
Most patients admitted to the ICU are initially in a coma and many will never awaken. Even if they regain consciousness, there may be long-term cognitive and functional disabilities. There are currently no specific treatments available to ICU professionals that are proven to limit brain damage and improve outcomes.
Cerebral oximetry is a non-invasive, painless, safe, and easy-to-use tool that detects reduced oxygen delivery to the brain using a sensor over the forehead. Previous research shows that reduced brain oxygen levels [(regional oxygen saturation (RSO2)] are predictive of a lower chance of awakening and having a good neurological recovery.
This study will assess treatment guided by cerebral oximetry during the initial 48 hours following cardiac arrest. Patients that are in a coma after their circulation has been restarted will be randomly allocated to either usual care based on international guidelines or a protocol aimed at maintaining RSO2 above 60% on both sides of the brain.
Cerebral oximetry will be recorded in all patients, but doctors will only be aware of it in one group. If RSO2 drops below 60% for more than 5 minutes, doctors will try to increase it. Actions taken to increase RSO2 may include raising the blood pressure by giving more intravenous fluid or using life-support drugs ("vasoconstrictors" like norepinephrine), stimulating the heart to pump more strongly with medications ("inotropes" like dobutamine, milrinone, or epinephrine), adjusting ventilator settings (to increase the amount of oxygen dissolved in blood or raise carbon dioxide levels, which increases blood flow to the brain), lowering the head of the bed (to increase blood flow to the brain), or giving a blood transfusion (only if the patient has anemia). When RSO2 has been corrected to at least 60% for more than 2 hours, doctors may reverse previous interventions. If they are unable to achieve the goal of 60%, they may lower the target. Efforts to maintain RSO2 in the target range will continue for 48 hours.
Investigators will assess how well the protocol works and whether it helps avoid critically low brain oxygen levels. Investigators will also measure various "biomarkers" in the blood that are released when the brain is damaged to see if they are lower when cerebral oximetry is used to guide treatment.
- Conditions
- Post-Cardiac Arrest Syndrome, Post Cardiac Arrest Brain Injury, Hypoxic-Ischemic Brain Injury
- Being tested
- Cerebral oximetry-guided treatment
- Keywords
- Heart Arrest, Hypoxia, brain, Out-of-Hospital Cardiac Arrest, Post-Cardiac Arrest Syndrome, Spectroscopy, Near-Infrared
- Medical subject headings
- Post-Cardiac Arrest Syndrome, Hypoxia-Ischemia, Brain, Heart Arrest, Hypoxia, Brain, Out-of-Hospital Cardiac Arrest
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cerebral oximetry-guided treatmentOther
Initial goals are consistent with ILCOR guidelines. When RSO2 < 60%, treatment options include:
- Raise MAP by 5 mmHg (recommended if MAPopt > MAPactual; maximum 85-90 mmHg).
- Raise PCO2 by 5 mmHg (maximum 50-55 mmHg);
- Increase PO2 to 100-150 mmHg (raise FIO2 or PEEP).
- Increase cardiac output using fluid (if intravascular volume depletion) or inotrope (if impaired systolic function).
- Lower head of bed (HOB) 15 degrees (consider reducing nutrition and suctioning stomach)
- If the HB concentration < 9-10 g/dL, transfuse one unit RBCs.
MAPopt (MAP range where autoregulation best preserved) determined once daily. The order of interventions are at the discretion of the most responsible physician. Treatments should occur within 15 minutes and be separated by at least 15 minutes. If treatments ineffective or considered unsafe, target can be dropped by 5% (minimum 50%). If RSO2 stable for 2-4 hours, previous interventions can be reversed.
| Study group | Role | What they receive |
|---|---|---|
| Cerebral oximetry-guided treatment | Experimental | Clinicians are unmasked to regional oxygen saturation levels and attempt to maintain it at 60% or above. Receives: Other: Cerebral oximetry-guided treatment |
| Standard care | No intervention | Clinicians are unaware of regional oxygen saturation levels and manage patients in accordance with international (ILCOR) guidelines. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Area under the curve (RSO2 < 60%)
Sum of right and left forehead area under the curve (AUC), where AUC = (average reduction in RSO2 below 60% per minute) x (2880 minutes)
Measured: 48 hours (2880 minutes)
Secondary outcomes (9)
Area under the curve (RSO2 < 60%) in patients where initial RSO2 < 60%
Sum of right and left forehead area under the curve (AUC), where AUC = (average reduction in RSO2 below 60% per minute) x (2880 minutes) in patients where initial RSO2 < 60%
Measured: 48 hours (2880 minutes)
Proportion of monitoring time with RSO2 < 60%
(Number of minutes with RSO2 < 60%) / (Number of minutes monitored)
Measured: Maximum of 48 hours (2880 minutes)
Proportion of monitoring time with RSO2 < 60% in patients where initial RSO2 < 60%
(Number of minutes with RSO2 < 60%) / (Number of minutes monitored)
Measured: Maximum of 48 hours (2880 minutes)
Change in RSO2 over time in patients where baseline level < 60%
Assessed using generalized estimating equation linear models with autoregressive correlation structure
Measured: Initial 6 hours
Dichotomized Cerebral Performance Category (CPC)
CPC 1-2 = favourable outcome, CPC 3-5 = poor outcome
Measured: 3 months
28-day mortality
Proportion dead at 28 days post-arrest
Measured: 28 days
Difference between baseline and day 3 biomarker levels
Baseline level measured as soon as possible following ROSC. Day 3 level measured on third morning in ICU at about 8 a.m.. Biomarkers measured will include neuron specific enolase, neurofilament light, and tau.
Measured: 3 days
Optic nerve sheath diameter
Average of bilateral measurements, two planes per eye (4 total measurements)
Measured: Days 1, 2, and 3 post-arrest
Serious Adverse Events (SAE)
Neurologic: seizures, herniation syndromes, progression to death by neurological criteria Cardiovascular: arrhythmias, development of cardiogenic shock, recurrent cardiac arrest Respiratory: ARDS, pulmonary edema Gastrointestinal: mesenteric ischemia Acute kidney injury: based on KDIGO definition
Measured: Initial 7 days post-arrest
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Sep 2026
- Study start10 Oct 2025
- Primary completionFeb 2027 (estimated)
- Study completionMay 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Post-Cardiac Arrest SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 44 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Calgary
- Sponsor type
- University, hospital or other
- Collaborators
- Canadian Intensive Care Foundation
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07829887
- Sponsor's protocol ID
- REB19-0216_REN8
- Acronym
- COMPACT
- Status last verified
- Aug 2026
- First submitted
- 18 Aug 2026
- Last updated
- 21 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Phillips A, Bencsik C, Bains I, McKenzie E, Wong A, Couillard P, Kromm JA, Kramer AH. Relationship Between Cerebral Oximetry and Outcomes in Post-Cardiac Arrest Patients: A Systematic Review and Meta-Analysis. Crit Care Explor. 2026 Jul 2;8(7):e1427. doi: 10.1097/CCE.0000000000001427. eCollection 2026 Jul 1.
PubMed 42390940