ALPS
Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest
Patient / Population Intervention / Exposure Comparison Outcome
In 3,026 adults with OHCA and shock-refractory VF/pVT, amiodarone or lidocaine did not improve survival to hospital discharge versus placebo.
N
3,026
Design
Double-blind RCT, North America
Endpoint
Survival to hospital discharge
Relevance
3
Result24.4% (amiodarone) vs 23.7% (lidocaine) vs 21.0% (placebo); benefit in witnessed bystander-arrest subgroup.
Kudenchuk PJ, et al. N Engl J Med. 2016;374(18):1711-1722. 10.1056/NEJMoa1514204
Discussion & critique
Antiarrhythmics remain a weak recommendation; bystander CPR and early defibrillation are the real life-savers.