Acute cardiac care & resuscitation
Vasopressin and steroids in addition to adrenaline in cardiac arrest (VAST-A) – A randomised pilot study
Authors' conclusion
In this IHCA pilot study, randomisation to adrenaline, vasopressin, and corticosteroids compared to controls was safe, but feasibility needs improvement for adequate enrolment in the VAST-A main study.
Study context
- Population
- Witnessed in-hospital cardiac arrests (in-hospital cardiac arrest (IHCAs)) meeting criteria for adrenalinerandomised, of 183 screened IHCAs
- Participants
- 39 arrests
- Comparison
- Adrenaline, vasopressin, and corticosteroids or adrenaline and placebo
- Interventionn = 16
- Controln = 23
- Primary endpoint
- Feasibility (e.g., protocol adherence, event times, enrolment rate), and safety
Methodological detailsthree Swedish hospitals
- Three Swedish hospitals
Primary result
As reported in the abstract
| Group | Median time to adrenaline administration | Median time to vasopressin/placebo |
|---|---|---|
| Intervention | 7:00 (IQR 3:00-10:00) | 10:30 (IQR 9:30-12:15) |
| Control | 5:00 (IQR 2:30-8:30) | 9:00 (IQR 5:00-11:00) |
Median time to adrenaline administration
Intervention7:00 (IQR 3:00-10:00)
Control5:00 (IQR 2:30-8:30)
Median time to vasopressin/placebo
Intervention10:30 (IQR 9:30-12:15)
Control9:00 (IQR 5:00-11:00)
- Enrolment rate
- 0.8 patients/hospital bed/month
- Protocol deviations at the scene of the arrest
- four patients
- Protocol deviations in the intensive care unit
- three patients
Secondary outcomes
Return of spontaneous circulation (secondary)
Cardiac arrests in general wards (descriptive)
- Cardiac arrests in general wards
- n = 17/39, 44%
Original publication
Vasopressin and steroids in addition to adrenaline in cardiac arrest (VAST-A) – A randomised pilot study. Resuscitation. Published 26 March 2025. doi:10.
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