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Out-Of-Hospital Cardiac ArrestRIPOST-CANCT06473207

Neuroprotective Effect of Remote Ischemic Post-conditioning in Out-of-hospital Cardiac Arrest

A study testing Remote ischemic post conditioning sessions in people with Out-Of-Hospital Cardiac Arrest, run by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer at 1 site in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Patients admitted to intensive care unit (ICU) following an out-of-hospital cardiac arrest (OHCA) have a high morbidity and mortality rate, primarily due to ischemia-reperfusion (I/R) syndrome leading to anoxic-ischemic brain injury. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Out-Of-Hospital Cardiac Arrest
What is being tested?
Remote ischemic post conditioning sessions
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
48 participants
Where
1 siteFrance
Study dates
11 Jan 2025to Apr 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Out-of-hospital cardiac arrest with stable return of spontaneous circulation (ROSC > 20 minutes)
  • Patient receiving invasive mechanical ventilation for coma (Glasgow score < 8)
  • Availability of a lower limb without intravenous infusion or tension cuff positioned on it
  • Randomization and application of the first session of the tested procedure within 4 hours after ROSC
  • Consent of a next-of-kin or inclusion in emergency procedure

Who cannot join

  • Age < 18 y.o or pregnancy
  • Patient unable to walk without assistance, unable to support himself properly without assistance, bedridden, incontinent and requiring nursing constant attention and care (corresponding to a mRS equal to 4 or 5)
  • Interval between cardiac arrest and ROSC (no flow + low flow) estimated > 60 minutes
  • Unwitnessed cardiac arrest with asystole as first rhythm
  • In-hospital cardiac arrest
  • Refractory cardiac arrest (no ROSC considered as stable)
Show all 15Show fewer
  • Cardiac arrest from traumatic, hemorrhage, stroke or hanging supposed origin
  • Mean arterial pressure < 65mmHg persisting despite appropriate vascular filling and vasopressor and/or inotropic support
  • Active uncontrolled bleeding
  • Contraindication or not possible to use a pneumatic tourniquet on none of the two lower limbs (amputations, intravenous infusion positioned on both lower limbs, tourniquet size incompatible with patient morphology)
  • Implementation of extracorporeal arteriovenous circulation for refractory cardiac arrest or refractory cardiogenic shock before inclusion
  • Patient already included in this study
  • Inclusion in another interventional study which purpose is to improve prognosis after a cardiac arrest
  • Judicial protection measure
  • Patient without French social security

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

France1 site, 1 recruiting
  • Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer

    Toulon, Var, 83100

    Jonathan Chelly, MD, 0494145124 ext. +33, Jonathan.chelly@ch-toulon.fr

    Recruiting

Other trials in France

About this study

Official title: Neuroprotective Effect of Remote Ischemic Post-conditioning in Out-of-hospital Cardiac Arrest : a Randomized Open Label Controlled Trial

Patients admitted to intensive care unit (ICU) following an out-of-hospital cardiac arrest (OHCA) have a high morbidity and mortality rate, primarily due to ischemia-reperfusion (I/R) syndrome leading to anoxic-ischemic brain injury. Despite current recommended advanced life support therapies, no specific treatment or procedure has yet been shown to improve the neurological outcome of such patients.

Remote ischemic post-conditioning (RIPOST) which usually consists of applying brief and repeated cycles of ischemia alternating with reperfusion by inflating and deflating a blood pressure cuff or a pneumatic tourniquet placed around a limb, is a promising strategy to protect organs against I/R injury, including brain. Regarding cardiac arrest, pre-clinical studies have demonstrated an improvement in neurological outcome in animal subjects treated with RIPOST after cardiopulmonary resuscitation.

The aim of our study is to demonstrate the benefit of early RIPOST in OHCA patients in reducing neurological injury and organ failure related to I/R syndrome.

Read the detailed description

The RIPOST trial is a prospective, single-center, randomized, open-label, parallel group trial.

Patients with inclusion criteria will be randomized in two parallel groups:

  • Experimental group: standard of care associated to 3 RIPOST sessions : one within the 4 hours following cardiac arrest, one 12 hours after cardiac arrest and one 24 hours after cardiac arrest. A RIPOST session = four cycles of cuff inflation to 200 mmHg for five minutes and then deflation to 0 mmHg for another five minutes, using an inflatable thigh tourniquet (total duration of the session = 40 minutes).
  • Control group: standard of care associated to 3 sham sessions at inclusion, 24, and 48 hours after inclusion. A sham session = application of the thigh tourniquet during 40 minutes without any inflation.

Inclusion duration: 36 months

Patient participation duration: 3 months

Study duration: 39 months

Being tested
Remote ischemic post conditioning sessions, Sham sessions
Keywords
Remote ischemic conditioning, Out-of-hospital cardiac arrest, Neuroprotection, Cardiac arrest
Medical subject headings
Out-of-Hospital Cardiac Arrest, Heart Arrest

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Remote ischemic post conditioning sessionsOther

    Also called RIPOST

    Three sessions of RIPOST (within the 4 hours following cardiac arrest and then 12 and 24 hours after cardiac arrest), as follows: four cycles of cuff inflation to 200 mmHg for 5 min and then deflation to 0 mmHg for another 5 min (40 min total duration of the intervention), using an inflatable thigh tourniquet

  • Sham sessionsOther

    Also called Sham

    Three sessions of a sham procedure (within the 4 hours following cardiac arrest and then 12 and 24 hours after cardiac arrest), as follows : application of a thigh tourniquet during 40 min without any inflation

Study groups in NCT06473207
Study groupRoleWhat they receive
Remote ischemic post-conditioning (RIPOST)ExperimentalPatients subjected to three sessions of RIPOST (within the 4 hours following cardiac arrest and then 12 and 24 hours after cardiac arrest)
Receives: Other: Remote ischemic post conditioning sessions
Sham procedureSham comparatorPatients subjected to three sessions of a sham procedure (within the 4 hours following cardiac arrest and then 12 and 24 hours after cardiac arrest)
Receives: Other: Sham sessions

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Neurofilament light chain (NFL) blood level evolution between 6 and 72 hours after cardiac arrest occurrence

    Blood samples will be performed at 6 and 72 hours after cardiac arrest to monitor NFL level evolution and this evolution will be compared between both arms (RIPOST and sham groups)

    Measured: 72 hours after out-of-hospital cardiac arrest occurrence

Secondary outcomes (7)
  1. Sepsis organ failure assessment score (SOFA)

    SOFA will be assessed at 24, 48 and 72 hours after cardiac arrest, and compared between both arms

    Measured: 72 hours after out-of-hospital cardiac arrest occurrence

  2. Rate of patients with NFL peak level >500 pg/mL

    Blood samples will be performed at 6, 24, 48 and 72 hours after cardiac arrest to monitor NFL peak level and the rate of patients who will present a NFL peak level > 500 pg/mL will be compared between both arms.

    Measured: 72 hours after out-of-hospital cardiac arrest occurrence

  3. Neuron-specific enolase (NSE) blood level evolution between 6 and 72 hours after cardiac arrest occurrence

    Blood samples will be performed at 6, 24, 48 and 72 hours after cardiac arrest to monitor NSE levels and their evolution will be compared between both arms (RIPOST and sham groups)

    Measured: 72 hours after out-of-hospital cardiac arrest occurrence

  4. S100B protein (PS100B) blood level evolution between 6 and 72 hours after cardiac arrest occurrence

    Blood samples will be performed at 6, 24, 48 and 72 hours after cardiac arrest to monitor PS100B levels and their evolution will be compared between both arms (RIPOST and sham groups)

    Measured: 72 hours after out-of-hospital cardiac arrest occurrence

  5. ICU mortality rate from multi-organ failure and from neurological injury

    Death mode at ICU discharge will be collected in both arms

    Measured: At intensive care unit (ICU) discharge, up to 28 days

  6. Modified Rankin Scale (mRS)

    Modified Rankin Scale (mRS) will be assessed for both arms, at patient's ICU discharge and at day 90 after inclusion. This scales goes from 0 to 6, 0 corresponding to the absence of cognitive deficits and 6 to death.

    Measured: 90 days after out-of-hospital cardiac arrest occurrence

  7. Post out-of-hospital cardiac arrest event occurrence

    Post out-of-hospital cardiac arrest event occurrence will be compared between both arms within the 24 hours following cardiac arrest. Events that will be considered are : unexpected cardiac arrest in ICU, iatrogenic events, limb ischemia, occlusive syndrome, digestive ischemia and thromboembolic complications.

    Measured: 24 hours after out-of-hospital cardiac arrest occurrence

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jun 2024
  2. Study start11 Jan 2025
  3. Primary completionJan 2028 (estimated)
  4. Study completionApr 2028 (estimated)

Resources

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
48 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06473207
Sponsor's protocol ID
2023-CHITS-010
Other IDs
2023-A02457-38
Acronym
RIPOST-CA
Status last verified
Jul 2026
First submitted
17 Jun 2024
Last updated
7 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Ho AFW, Chong J, Ong MEH, Hausenloy DJ. Remote Ischemic Conditioning in Emergency Medicine-Clinical Frontiers and Research Opportunities. Shock. 2020 Mar;53(3):269-276. doi: 10.1097/SHK.0000000000001362.

    PubMed 32045394
  • Kloner RA, Shi J, Dai W, Carreno J, Zhao L. Remote Ischemic Conditioning in Acute Myocardial Infarction and Shock States. J Cardiovasc Pharmacol Ther. 2020 Mar;25(2):103-109. doi: 10.1177/1074248419892603. Epub 2019 Dec 11.

    PubMed 31823646
  • Albrecht M, Meybohm P, Broch O, Zitta K, Hein M, Grasner JT, Renner J, Bein B, Gruenewald M. Evaluation of remote ischaemic post-conditioning in a pig model of cardiac arrest: A pilot study. Resuscitation. 2015 Aug;93:89-95. doi: 10.1016/j.resuscitation.2015.05.019. Epub 2015 Jun 4.

    PubMed 26051813
  • England TJ, Hedstrom A, O'Sullivan SE, Woodhouse L, Jackson B, Sprigg N, Bath PM. Remote Ischemic Conditioning After Stroke Trial 2: A Phase IIb Randomized Controlled Trial in Hyperacute Stroke. J Am Heart Assoc. 2019 Dec 3;8(23):e013572. doi: 10.1161/JAHA.119.013572. Epub 2019 Nov 21.

    PubMed 31747864
  • Moseby-Knappe M, Mattsson N, Nielsen N, Zetterberg H, Blennow K, Dankiewicz J, Dragancea I, Friberg H, Lilja G, Insel PS, Rylander C, Westhall E, Kjaergaard J, Wise MP, Hassager C, Kuiper MA, Stammet P, Wanscher MCJ, Wetterslev J, Erlinge D, Horn J, Pellis T, Cronberg T. Serum Neurofilament Light Chain for Prognosis of Outcome After Cardiac Arrest. JAMA Neurol. 2019 Jan 1;76(1):64-71. doi: 10.1001/jamaneurol.2018.3223.

    PubMed 30383090
  • Chelly J, Cheyssac R, Bertrand T, Gardan V, Jobic A, Rahmati M, Lambert R, Durif J, Sapin V, Cariou A, Aria AD, Ducros L. Neuroprotective effect of early remote ischaemic post-conditioning after out-of-hospital cardiac arrest (RIPOST-CA): study protocol for a randomised, single-blinded, monocentric, controlled trial. Resusc Plus. 2026 Sep 24;32:101503. doi: 10.1016/j.resplu.2026.101503. eCollection 2026 Nov.

    PubMed 42891020

Questions about this trial

What is this clinical trial studying?

A study testing Remote ischemic post conditioning sessions in people with Out-Of-Hospital Cardiac Arrest, run by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 7 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Chelly Jonathan, MD (0494145124 ext. +33, Jonathan.chelly@ch-toulon.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Neurofilament light chain (NFL) blood level evolution between 6 and 72 hours after cardiac arrest occurrence (time frame: 72 hours after out-of-hospital cardiac arrest occurrence). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06473207, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Jul 2026.

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