Cardiac arrest & resuscitation
Expedited transfer from the scene for refractory out-of-hospital cardiac arrest in Australia: a prospective, multicentre, parallel, open label, randomised clinical trial
Authors' conclusion
Among patients with refractory out-of-hospital cardiac arrest, expedited intra-arrest transport did not significantly improve survival with neurologically favourable outcome.
Study context
- Population
- Adults 18–70 years with witnessed refractory of hospital cardiac arrest (OHCA) of presumed medical cause, bystander cardiopulmonary resuscitation (CPR), initial shockable rhythm or pulseless electrical activity without ROSC after 15 mins of ALS or three rounds of professional resuscitation; greater Sydney, Australia206 enrolled
- Participants
- 197 adults
- Comparison
- Expedited intra-arrest transport vs standard transport strategy
- Expeditedn = 102
- Standardn = 95reference
- Primary endpoint
- Survival with good neurological outcome (CPC 1-2), stratified by initial rhythm
- Follow-up
- Hospital discharge
Methodological detailsprospective, parallel, multicentre, open-label, superiority, Follow-up until death or 6 months, Randomised 1:1 at the scene by paramedics; masking not possible
- Prospective
- Parallel
- Multicentre
- Open-label
- Superiority
- Follow-up until death or 6 months
- Randomised 1:1 at the scene by paramedics; masking not possible
Primary result
As reported in the abstract
Survival with good neurological outcome (CPC 1-2)
Each group vs standardRisk difference in survival with good neurological outcome (95% CI)
Expedited
−1.1%(−12.2% to 10.0%)
Each group vs standardAdjusted RR of survival with good neurological outcome (95% CI)P value
Expedited
0.95(0.50–1.8)
P = 0.87Safety
Hypoxic brain injury
- Hypoxic brain injury: proportions of the 35 patients with hypoxic brain injury
Serious adverse events
- Patients with a serious adverse event
- 38 (19%)
- Hypoxic brain injury
- 35 (92%)
- Cerebral stroke (standard arm)
- 1 (3%)
- Pulmonary haemorrhage (standard arm)
- 1 (3%)
- Gastrointestinal haemorrhage (standard arm)
- 1 (3%)
- Adverse events evenly distributed between arms; no unanticipated adverse events
Original publication
Expedited transfer from the scene for refractory out-of-hospital cardiac arrest in Australia: a prospective, multicentre, parallel, open label, randomised clinical trial. Lancet Respir Med. Published 22 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →