Cardiac arrest & resuscitation
Intraosseous versus intravenous access in adult out-of-hospital cardiac arrest: a Bayesian secondary analysis of the PARAMEDIC-3 randomised controlled trial
Authors' conclusion
Based on non-informative priors, which represent minimal prior knowledge of the treatment effect, an intraosseous-first strategy in adult out-of-hospital cardiac arrest is more likely to be harmful, rather than beneficial. However, the low probability of a moderate or large treatment effect suggests that the overall treatment effect is likely to be modest.
Study context
- Population
- Adults with OHCA requiring vascular accessrandomised
- Participants
- 6,082 adults
- Comparison
- Intraosseous-first vs intravenous-first vascular access strategy
Methodological detailspre-planned, Bayesian, non-informative priors, adjusted for key baseline characteristics
- Pre-planned
- Bayesian
- Non-informative priors
- Adjusted for key baseline characteristics
Primary result
As reported in the abstract
Posterior probability intraosseous-first improved 30-day survival (OR > 1.0)
18.4%
Probability intraosseous-first inferior, any effect (OR < 1.0)
81.6%
Probability intraosseous-first inferior, small effect (OR < 0.9)
55.0%
Probability intraosseous-first inferior, moderate effect (OR < 0.75)
13.4%
Further findings
Favourable neurological outcome at hospital discharge
- Findings comparable to 30-day survival
ROSC at hospital handover
- Posterior probability intraosseous-first inferior (OR < 1.0)
- 98.0%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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