1. Effect of vasopressin and methylprednisolone vs. placebo on long-term outcomes in patients with in-hospital cardiac arrest a randomized clinical trial.
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Granfeldt, Asger, Sindberg, Birthe, Isbye, Dan, Kjærgaard, Jesper, Kristensen, Camilla M., Darling, Søren, Zwisler, Stine T., Fisker, Stine, Schmidt, Jens Christian, Kirkegaard, Hans, Grejs, Anders M., Rossau, Jørgen R.G., Larsen, Jacob M., Rasmussen, Bodil S., Riddersholm, Signe, Iversen, Kasper, Schultz, Martin, Nielsen, Jakob L., Løfgren, Bo, and Lauridsen, Kasper G.
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LEVOSIMENDAN , *CARDIAC arrest , *VASOPRESSIN , *CARDIAC patients , *METHYLPREDNISOLONE , *PLACEBOS , *CARDIOPULMONARY resuscitation , *HOSPITALS , *RESEARCH , *ADRENALINE , *RESEARCH methodology , *EVALUATION research , *COMPARATIVE studies , *RANDOMIZED controlled trials , *QUALITY of life - Abstract
Objective: The primary results from the Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest (VAM-IHCA) trial have previously been reported. The objective of the current manuscript is to report long-term outcomes.Methods: The VAM-IHCA trial was a multicenter, randomized, double-blind, placebo-controlled trial conducted at ten hospitals in Denmark. Adult patients (age ≥ 18 years) were eligible for the trial if they had an in-hospital cardiac arrest and received at least one dose of epinephrine during resuscitation. The trial drugs consisted of 40 mg methylprednisolone (Solu-Medrol®, Pfizer) and 20 IU of vasopressin (Empressin®, Amomed Pharma GmbH) given as soon as possible after the first dose of epinephrine. This manuscript report outcomes at 6 months and 1 year including survival, survival with favorable neurological outcome, and health-related quality of life.Results: 501 patients were included in the analysis. At 1 year, 15 patients (6.3%) in the intervention group and 22 patients (8.3%) in the placebo group were alive corresponding to a risk ratio of 0.76 (95% CI, 0.41-1.41). A favorable neurologic outcome at 1 year, based on the Cerebral Performance Category score, was observed in 14 patients (5.9%) in the intervention group and 20 patients (7.6%) in the placebo group (risk ratio, 0.78 [95% CI, 0.41-1.49]. No differences existed between groups for favorable neurological outcome and health-related quality of life at either 6 months or 1 year.Conclusions: Administration of vasopressin and methylprednisolone, compared with placebo, in patients with in-hospital cardiac arrest did not improve long-term outcomes in this trial. [ABSTRACT FROM AUTHOR]- Published
- 2022
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