Acute cardiac care & resuscitationMeta-analysis
Intravenous or intraosseous vascular access in cardiac arrest: an individual participant data meta-analysis
- systematic review and individual participant data meta-analysis of randomized trials
- PRISMA-IPD
- logistic regression with adjustment for prognostic factors
- Bayesian analyses using prespecified prior distributions
- GRADE methodology
Authors' conclusion
In this individual participant data meta-analysis of two randomized trials, intraosseous-first compared with intravenous-first vascular access during out-of-hospital cardiac arrest did not result in a statistically significant difference in 30-day survival, sustained return of spontaneous circulation, and favorable neurological outcome.
Study context
- Population
- Patients with out-of-hospital cardiac arrest in randomized trials comparing intraosseous-first with intravenous-first vascular accessTwo randomized trials provided individual participant data
- Participants
- 7,561 patients
- Comparison
- intraosseous-first compared with intravenous-first vascular access during cardiac arrest
Pooled result
30-day survival · 30 days
Odds ratio
1.01
95% CI 0.81–1.25
intraosseous vs intravenous
odds ratio 1.01 (95% CI 0.81–1.25)
As reported in the abstract
Further pooled results
| Outcome | odds ratio (95% CI) | |
|---|---|---|
| favorable neurological outcome · 30 days or hospital discharge · low certainty of evidence | 1.08 (0.83–1.41) | |
| sustained return of spontaneous circulation | 0.90 (0.81–1.01) | |
| 0.512Odds ratio (log scale) |
- sustained return of spontaneous circulation: point estimate favored intravenous access; not statistically significant; low certainty of evidence
Bayesian analyses
- high probability that any difference between the two strategies was small
Original publication
Intravenous or intraosseous vascular access in cardiac arrest: an individual participant data meta-analysis. Resuscitation. Published 11 September 2026. doi:10.1016/j.resuscitation.2026.111304
Summarised from the published abstract; every number is checked against it