Acute cardiac care & resuscitationRandomised controlled trial
A randomised controlled trial of defibrillation with manual pressure augmentation during out-of-hospital cardiac arrest
- Investigator-initiated, open-label, two-arm, cluster-randomised controlled trial
- 216 ambulance stations in Victoria, Australia
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 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
Primary result
As reported in the abstract
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:10.1016/j.resuscitation.2026.111121
Summarised from the published abstract; every number is checked against it