Acute cardiac care & resuscitation
Intraosseous vs. intravenous access during out-of-hospital cardiac arrest: a Bayesian secondary analysis of a randomised clinical trial
Authors' conclusion
The probability of a clinically meaningful difference in return of spontaneous circulation between intraosseous and intravenous access for out-of-hospital cardiac arrest was very low, while results for 30-day outcomes were uncertain, with no strong evidence favouring either method.
Study context
- Population
- Adults with non-traumatic out-of-hospital cardiac arrestadults in the IVIO trial
- Participants
- 1,479 adults
- Comparison
- Intraosseous to intravenous access
Methodological detailspre-planned in the protocol, non-informative and informative priors
- Pre-planned in the protocol
- Non-informative and informative priors
Primary result
As reported in the abstract
Sustained return of spontaneous circulation (non-informative priors)
Posterior probability risk ratio > 1.27, favouring intraosseous access
1.2%
Posterior probability risk ratio < 0.79 [1/1.27], favouring intravenous access
< 0.1%
Further findings
30-day survival and survival with a favourable neurologic outcome
- Posterior probability risk ratio intraosseous vs intravenous between 0.83 (1/1.2) and 1.2, 30-day survival
- 58%
- Posterior probability risk ratio intraosseous vs intravenous between 0.83 (1/1.2) and 1.2, survival with favourable neurologic outcome
- 55%
All outcomes, informative priors
- Results did not provide probabilities strongly favouring either intraosseous or intravenous access
- Informative priors
Original publication
Intraosseous vs. intravenous access during out-of-hospital cardiac arrest: a Bayesian secondary analysis of a randomised clinical trial. Resuscitation. Published 17 May 2025. doi:10.
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