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01.12.2014 | Study protocol | Ausgabe 1/2014 Open Access

BMC Emergency Medicine 1/2014

Passive leg raise (PLR) during cardiopulmonary (CPR) – a method article on a randomised study of survival in out-of-hospital cardiac arrest (OHCA)

BMC Emergency Medicine > Ausgabe 1/2014
María F Jiménez-Herrera, Youcef Azeli, Eva Valero-Mora, Isaac Lucas-Guarque, Alfonso López-Gomariz, Elena Castro-Naval, Christer Axelsson
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-227X-14-15) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

The project will be led by the Department of Nursing at the URV in Tarragona and will include researchers from the Department of Statistics and Mathematics and the Department of Basic Medical Sciences, as well as clinical practitioners with extensive experience of cardiopulmonary resuscitation (CPR) research and practice and experts in the field from the University of Borås, Sweden. All authors read and approved the final manuscript.



It is estimated that about 275,000 inhabitants experience an out-of-hospital cardiac arrest (OHCA) every year in Europe. Survival in out-of-hospital cardiac arrest is relatively low, generally between five per cent and 10%. Being able to explore new methods to improve the relatively low survival rate is vital for people with these conditions. Passive leg raise (PLR) during cardiopulmonary resuscitation (CPR) has been found to improve cardiac preload and blood flow during chest compressions. The aim of our study is to evaluate whether early PLR during CPR also has an impact on one-month survival in sudden and unexpected out-of-hospital cardiac arrest (OHCA).


A prospective, randomized, controlled trial in which all patients (≥18 years) receiving out-of hospital CPR are randomized by envelope to be treated with either PLR or in the flat position. The ambulance crew use a special folding stool which allows the legs to be elevated about 20 degrees. Primary end-point: survival to one month. Secondary end-point: survival to hospital admission to one month and to one year with acceptable cerebral performance classification (CPC) 1–2.


PLR is a simple and fast maneuver. We believe that the greatest benefit with PLR is when performed early in the process, during the first minutes of CPR and before the first defibrillation. To reach power this study need 3000 patients, we hope that this method article will encourage other sites to contact us and take part in our study.

Trial registration NCT01952197.
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