Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial
RCT (n=501) found use of vasopressin and methylprednisolone significantly increased likelihood of return of spontaneous circulation vs. placebo (42% vs. 33%; risk ratio, 1.30; 95% CI, 1.03-1.63]; p=0 .03).), but outcome (positive/negative) for long-term survival is uncertain.
Source:
Journal of the American Medical Association
SPS commentary:
An editorial notes that as with all resuscitation research, there are challenges with conducting studies involving patients with cardiac arrest in both out-of-hospital and in-hospital environments, highlighting the need for enhanced global efforts to standardise the design, implementation, and analysis of resuscitation studies to improve external validity and reproducibility. It calls for additional research to further define the effect of vasopressin and steroids, and other interventions, on outcomes for patients with in-hospital cardiac arrest, evaluated in clinical trials specifically powered to test a difference in survival with good neurologic function. Until then, it concludes that the use of vasopressin and steroids for patients with in-hospital cardiac arrest is not ready for usual care but may be considered when patients remain unresponsive to more conventional treatments.