Prehospital high-dose methylprednisolone in resuscitated out-of-hospital cardiac arrest patients (STEROHCA): a randomized clinical trial

• DOI: 10.1007/s00134-023-07247-w
• Publication Date: 2023-11-09T08:24:22Z
• Authors: Laust E. R. Obling; Rasmus P. Beske; Martin A. S. Meyer; Johannes Grand; Sebastian Wiberg; Benjamin Nyholm; Jakob Josiassen; Frederik T. Sønde...; Thomas Mohr; Anders Damm-Hejmdal; Mette Bjerre; Ruth Frikke-Schmidt; Fredrik Folke; Jacob E. Møller; Jesper Kjaergaard; Christian Hassager
• Keywords: Interquartile range

Patients who are successfully resuscitated following out-of-hospital cardiac arrest (OHCA) still at a high risk of neurological damage and death. Inflammation brain injury components the post-cardiac syndrome, can be assessed by systemic interleukin 6 (IL-6) neuron-specific enolase (NSE). Anti-inflammatory treatment with methylprednisolone may dampen inflammation, thereby improving outcome. This study aimed to determine if prehospital high-dose could reduce IL-6 NSE in comatose OHCA patients. The STEROHCA trial was randomized, blinded, placebo-controlled, phase II performed two centers Denmark. Resuscitated patients suspected etiology were randomly assigned 1:1 single intravenous injection 250 mg or placebo. co-primary outcome reduction NSE-blood levels measured daily for 72 h from admission. main secondary survival 180 days follow-up. We randomized 137 (n = 68) placebo 69). found reduced (p < 0.0001) intervention group, median (interquartile range, IQR) 24 2.1 pg/ml (1.0; 7.1) 30.7 (14.2; 59) group. observed no difference between groups 0.22), 48 18.8 ug/L (14.4; 24.6) 14.8 (11.2; 19.4) respectively. In 51 (75%) survived 44 (64%) Prehospital patients, resulted after h, but did not levels.