Acute cardiac care & resuscitationRandomised controlled trial
A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest
- Randomised controlled trial
- multicentre
- open-label
- 11 UK emergency medical systems
Authors' conclusion
Among adults with out-of-hospital cardiac arrest requiring drug therapy, the use of an intraosseous-first vascular access strategy did not result in higher 30-day survival than an intravenous-first strategy.
Study context
- Population
- Adults with OHCA needing vascular access for drug administration
- Participants
- 6,082 adults
- Comparison
- Intraosseous-first vs intravenous-first vascular access strategy
- Intraosseousn = 3,040
- Intravenousn = 3,042reference
- Primary endpoint
- Survival
- Follow-up
- 30 days
Primary result
As reported in the abstract
Adjusted odds ratio
0.94
95% CI 0.68–1.32
P = 0.74
Events by treatment group
Intraosseous vs Intravenous
adjusted OR 0.94 (95% CI 0.68–1.32); P = 0.74
Secondary outcomes
| Outcome | Intraosseous | Intravenous | adjusted OR (95% CI) | |
|---|---|---|---|---|
| Favorable neurologic outcome (modified Rankin scale ≤3) · hospital discharge · no adjustment for multiplicity | 2.7% | 2.8% | 0.91 (0.57–1.47) | |
| denominator | 2994 | 2986 | ||
| Return of spontaneous circulation at any time · no adjustment for multiplicity | 36.0% | 39.1% | 0.86 (0.76–0.97) | |
| denominator | 3031 | 3035 | ||
| 0.512Adjusted odds ratio (log scale) |
Safety
| Outcome | Intraosseous | Intravenous |
|---|---|---|
| Adverse events | 1 events | Not reported in the abstract |
- Adverse events — One adverse event reported during the trial, in the intraosseous group
- 1
Original publication
A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest. N Engl J Med. Published 31 October 2024. doi:10.1056/nejmoa2407780
Summarised from the published abstract; every number is checked against it