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IV therapy after cardiac arrest linked with improvement in short-term survival
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Patients experiencing out-of-hospital cardiac arrest who were assigned intravenous drug administration with advanced cardiac life support derived a short-term survival benefit but not long-term benefit.
Researchers for the Norwegian study enrolled 1,183 patients with out-of-hospital nontraumatic cardiac arrest. Patients were administered treatment under an advanced cardiac life support protocol with or without IV drug administration. Then, 851 of these patients were randomly assigned, with 418 included in the IV therapy group and 433 without IV therapy. The primary outcome was survival to hospital discharge. Secondary outcome measures included one-year survival and survival with favorable neurological conditions.
The researchers reported that 44 (10.5%) of patients in the IV group survived to hospital discharge vs. 40 (9.2%) in the non-IV group (P=.61). There was no significant difference between the treatment groups for survival with favorable neurological outcome (9.8% IV vs. 8.1% non-IV). Short-term survival was higher in the IV group vs. non-IV (40% vs. 25%; P<.001). Upon adjustment for confounding variables, there was a greater chance of surviving until hospital discharge in the IV group vs. the non-IV group (adjusted OR=1.15; 95% CI, 0.69-1.91).
“Despite improved short-term survival among patients [randomly assigned to] IV access and drug administration, these nearly universal interventions were not associated with a statistically significant improvement in survival to hospital discharge,” the researchers concluded. “Larger trials examining resuscitation without IV access and drug administration, as well as of existing or new drugs, appear to be justified.”
For more information:
- Olasveengen TM. JAMA. 2009;302:2222-2229.