RINSE
Rapid Infusion of Cold Normal Saline
Patient / Population Intervention / Exposition Vergleich Endpunkt
In 1198 adults with out-of-hospital cardiac arrest, intra-arrest cold saline infusion did not improve survival to hospital discharge compared with standard prehospital care.
N
1.198
Design
Multicentre, randomised, single-blind, controlled trial in three Australian ambulance services (Victoria, South Australia, Western Australia); two concurrent parallel trials stratified by shockable versus non-shockable initial rhythm; adults in out-of-hospital cardiac arrest were randomised during CPR to a rapid intravenous infusion of ice-cold (4 °C) normal saline up to 2 L or to standard prehospital care with cooling started in hospital; mean 1193 (SD 647) mL infused; intention-to-treat; closed early at 48% of the planned 2512 patients because of changes in temperature management at major receiving hospitals.
Endpunkt
Survival at hospital discharge; secondary endpoints included return of spontaneous circulation, survival to hospital admission, temperature on hospital arrival and 12-month quality of life.
ErgebnisSurvival to hospital discharge was 10.2% with intra-arrest cold saline (618 patients) versus 11.4% with standard care (580 patients), P=0.71. Among patients with an initial shockable rhythm, return of spontaneous circulation was lower with cold saline (41.2% versus 50.6%, P=0.03). Intra-arrest cooling produced no trend toward improved outcome at hospital discharge.
Bernard SA, Smith K, Finn J, et al. Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline: The RINSE Trial (Rapid Infusion of Cold Normal Saline). Circulation. 2016;134(11):797-805. 10.1161/circulationaha.116.021989