Acute cardiac care & resuscitation
Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial
Authors' conclusion
Among patients with in-hospital cardiac arrest, administration of vasopressin and methylprednisolone, compared with placebo, significantly increased the likelihood of return of spontaneous circulation.
Study context
- Population
- Adults with in-hospital cardiac arrest501 analysed
- Participants
- 512 adults
- Comparison
- Vasopressin and methylprednisolone vs placebo
- Vasopressin and methylprednisolonen = 245
- Placebon = 267reference
- Primary endpoint
- Return of spontaneous circulation
Methodological detailsmulticentre, double-blind, placebo-controlled, 10 hospitals in Denmark
- Multicentre
- Double-blind
- Placebo-controlled
- 10 hospitals in Denmark
Primary result
As reported in the abstract
Vasopressin and methylprednisolone vs PlaceboRR for achieving ROSC (95% CI)P value
RR >1 favours intervention
1.30(1.03–1.63)
P = 0.03Vasopressin and methylprednisolone vs PlaceboRisk difference for achieving ROSC (95% CI)P value
Return of spontaneous circulation
9.6%(1.1%–18.0%)
P = 0.03Secondary outcomes
| Outcome | Vasopressin and methylprednisolone | Placebo | Estimate | P value | |
|---|---|---|---|---|---|
| Survival · 30 daysRR <1 = fewer alive with intervention | 9.7% | 12% | RR for being alive 0.83 (95% CI 0.50–1.37) | P = 0.48 | |
| Favorable neurologic outcome (CPC 1 or 2) · 30 days | 7.6% | 7.6% | RR for favorable neurologic outcome 1.00 (95% CI 0.55–1.83) | P > 0.99 | |
| 0.512Ratio (log scale) |
| Outcome | Estimate | P value | |
|---|---|---|---|
| Survival · 30 days | risk difference for being alive −2.0% (95% CI −7.5% to 3.5%) | P = 0.48 | |
| Favorable neurologic outcome (CPC 1 or 2) · 30 days | risk difference for favorable neurologic outcome 0.0% (95% CI −4.7% to 4.9%) | P > 0.99 | |
| −10−505Difference (linear scale) |
Safety
Hyperglycemia (patients with ROSC)
Hypernatremia (patients with ROSC)
Original publication
Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. Published 26 October 2021. doi:10.
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