Augmented-Medication CardioPulmonary Resuscitation Trials in out-of-hospital cardiac arrest: a pilot randomized controlled trial

• DOI: 10.1186/s13054-022-04248-x
• Publication Date: 2022-12-07T05:03:14Z
• Authors: June-sung Kim; Seung Mok Ryoo; Youn-Jung Kim; Chang Hwan Sohn; Shin Ahn; Dong Woo Seo; Seok In Hong; Sang-Min Kim; Bora Chae; Won Young Kim
• Keywords: Clinical endpoint

Abstract Background Previously conducted physician-centered trials on the usefulness of vasopressin have yielded negative results; thus, patient-oriented been warranted. We hypothesize that Augmented-Medication CardioPulmonary Resuscitation could be helpful for selected patients with out-of-hospital cardiac arrest (OHCA). Methods This is a double-blind, single-center, randomized, placebo-controlled trial in emergency department tertiary, university-affiliated hospital Seoul, Korea. A total 148 adults non-traumatic OHCA who had initial diastolic blood pressure (DBP) < 20 mm Hg via invasive arterial monitoring during early compression period were randomly assigned to two groups. Patients received dose 40 IU or placebo epinephrine. The primary endpoint was sustained return spontaneous circulation. Secondary endpoints survival discharge, and neurologic outcomes at discharge. Results Of 180 included patients, 32 excluded, enrolled trial. circulation achieved by 27 (36.5%) group 24 (32.4%) control (risk difference, 4.1%; P = .60). Survival discharge good did not differ between significantly higher median DBPs resuscitation than (16.0 vs. 14.5 Hg, 0.01). There no difference end-tidal carbon dioxide, acidosis, lactate levels baseline, 10 min, end-time. Conclusion Among refractory vasodilatory shock OHCA, administration vasopressin, compared placebo, increase likelihood