Cardiac arrest & resuscitation
A randomised controlled trial of defibrillation with manual pressure augmentation during out-of-hospital cardiac arrest
- prematurely terminated
- Prematurely terminated due to external safety reviews and operational delays, without outcome unblinding at termination
Authors' conclusion
In this prematurely terminated RCT, MPA reduced transthoracic impedance but did not improve survival or other clinical outcomes in initially shockable OHCA.
Study context
- Population
- Adults (≥18 years) with out-of-hospital cardiac arrest (OHCA) and a shockable rhythm receiving attempted resuscitation, 216 ambulance stations in Victoria, Australia (April 2022–January 2023)ITT population
- Participants
- 560 adults
- Comparison
- Defibrillation with manual pressure augmentation (MPA) vs standard defibrillation
- Interventionn = 279
- Controln = 281reference
- Primary endpoint
- Survival to hospital discharge
Methodological detailsinvestigator-initiated, open-label, two-arm, cluster-randomised, All shocks biphasic at 200 J, anterior-lateral pad position
- Investigator-initiated
- Open-label
- Two-arm
- Cluster-randomised
- All shocks biphasic at 200 J, anterior-lateral pad position
Primary result
As reported in the abstract
Each group vs controlAbsolute risk difference (95% CI)P value
Intervention
−0.1%(−8.2% to 8.0%)
P = 0.99Each group vs controlAOR for survival to hospital discharge (95% CI)P value
Intervention
1.00(0.71–1.40)
P = 0.99Further findings
12-month survival, favourable neurologic outcome, quality of life
- Similar between groups
Transthoracic impedance (ITT)
- Significantly reduced with MPA
- AR −8.5 O (95% CI −12.9, −4.1; p < 0.001)
Transthoracic impedance (per-protocol)
- Larger reduction with MPA in per-protocol analyses
- AR −15.0 O (95% CI −22.8, −7.2; p < 0.001)
Compliance with MPA
- Compliance with MPA low
- 23.6%
Safety
Perceptible shocks
- Uncommon and comparable across groups (per 1000 shocks delivered)
- 0.75 vs 0.71
Serious injuries
- No serious injuries occurred
Original publication
A randomised controlled trial of defibrillation with manual pressure augmentation during out-of-hospital cardiac arrest. Resuscitation. Published 4 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →