Acute cardiac care & resuscitation
A randomised controlled trial of defibrillation with manual pressure augmentation during out-of-hospital cardiac arrest
Authors' conclusion
In this prematurely terminated RCT, MPA reduced transthoracic impedance but did not improve survival or other clinical outcomes in initially shockable OHCA.
Study context
- Population
- Adults (≥18 years) with out-of-hospital cardiac arrest (OHCA) and a shockable rhythm receiving an attempted resuscitationintention-to-treat (ITT) population · intervention 279 · control 281
- Participants
- 560 adults
- Comparison
- defibrillation with manual pressure augmentation (MPA) compared with standard defibrillation
- interventionn = 279
- controln = 281reference
- Primary endpoint
- Survival to hospital discharge
Methodological details216 ambulance stations in Victoria, Australia
- 216 ambulance stations in Victoria, Australia
Primary result
As reported in the abstract
Survival to hospital discharge
Each group vs controlAbsolute risk difference [AR] (95% CI)
Intervention
−0.1%(−8.2% to 8.0%)
Each group vs controlAdjusted odds ratio [AOR] (95% CI)P value
Intervention
1.00(0.71–1.40)
P = 0.99Further findings
| Outcome | AR (O) (95% CI) | P value |
|---|---|---|
| Transthoracic impedance — intervention vs control · reduced with MPA | −8.5 (−12.9 to −4.1) | P < 0.001 |
| Transthoracic impedance — intervention vs control · per-protocol analyses | −15.0 (−22.8 to −7.2) | P < 0.001 |
Twelve-month survival, favourable neurologic outcome, and quality of life
- Similar between groups
Compliance with MPA
- Compliance with MPA was low
- 23.6%
Trial conduct
- Prematurely terminated due to external safety reviews and operational delays, without outcome unblinding at the time of termination
Safety
Perceptible shocks
Perceptible shocks
- No serious injuries occurred
Original publication
A randomised controlled trial of defibrillation with manual pressure augmentation during out-of-hospital cardiac arrest. Resuscitation. Published 4 May 2026. doi:10.
Summarised from the published abstract; every number is checked against it