Intravenous Drug Administration During Out-of-Hospital Cardi
Intravenous Drug Administration During Out-of-Hospital Cardiac Arrest
Paciente / Población Intervención / Exposición Comparación Desenlace
In 851 adults with out-of-hospital cardiac arrest, IV drugs during ACLS did not improve survival to hospital discharge versus ACLS without IV access.
N
851
Diseño
Prospective, open-label, single-system randomized controlled trial in the Oslo, Norway emergency medical service, May 2003 to April 2008; of 1183 attempted resuscitations, 851 adults with non-traumatic out-of-hospital cardiac arrest were included and allocated to ACLS with intravenous access and drugs (n=418) or ACLS without access to intravenous drugs (n=433). ClinicalTrials.gov NCT00121524.
Desenlace
Primary: survival to hospital discharge. Secondary: 1-year survival, survival with favourable neurological outcome, hospital admission with return of spontaneous circulation, and CPR quality (compression rate, pauses, ventilation rate).
ResultadoSurvival to hospital discharge 10.5% with intravenous drugs vs 9.2% without (P=.61; adjusted odds ratio 1.15, 95% CI 0.69-1.91). Hospital admission with return of spontaneous circulation was higher with drugs, 32% vs 21% (P<.001), but survival with favourable neurological outcome (9.8% vs 8.1%, P=.45) and 1-year survival (10% vs 8%, P=.53) did not differ. CPR quality was comparable and within guideline recommendations in both groups.
Olasveengen TM, Sunde K, Brunborg C, Thowsen J, Steen PA, Wik L. Intravenous drug administration during out-of-hospital cardiac arrest: a randomized trial. JAMA. 2009;302(20):2222-2229. 10.1001/jama.2009.1729