TY - JOUR
T1 - Effect of Vasopressin and Methylprednisolone vs. Placebo on Long-Term Outcomes in Patients with In-Hospital Cardiac Arrest A Randomized Clinical Trial
AU - Granfeldt, Asger
AU - Sindberg, Birthe
AU - Isbye, Dan
AU - Kjærgaard, Jesper
AU - Kristensen, Camilla M
AU - Darling, Søren
AU - Zwisler, Stine T
AU - Fisker, Stine
AU - Christian Schmidt, Jens
AU - Kirkegaard, Hans
AU - Grejs, Anders M
AU - R G Rossau, Jørgen
AU - Larsen, Jacob M
AU - Rasmussen, Bodil S
AU - Riddersholm, Signe
AU - Iversen, Kasper
AU - Schultz, Martin
AU - Nielsen, Jakob L
AU - Løfgren, Bo
AU - Lauridsen, Kasper G
AU - Sølling, Christoffer
AU - Pælestik, Kim
AU - Kjærgaard, Anders G
AU - Due-Rasmussen, Dorte
AU - Folke, Fredrik
AU - Charlot, Mette G
AU - Malene H G Jepsen, Rikke
AU - Wiberg, Sebastian
AU - Høybye, Maria
AU - Holmberg, Mathias J
AU - Andersen, Lars W
N1 - Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.
PY - 2022/6
Y1 - 2022/6
N2 - 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.
AB - 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.
KW - In-hospital cardiac arrest
KW - Long-term
KW - Methylprednisolone
KW - Outcomes
KW - Vasopressin
UR - http://www.scopus.com/inward/record.url?scp=85129770063&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2022.04.017
DO - 10.1016/j.resuscitation.2022.04.017
M3 - Journal article
C2 - 35490936
SN - 0300-9572
VL - 175
SP - 67
EP - 71
JO - Resuscitation
JF - Resuscitation
ER -