Cardiac arrest & resuscitation
Intraosseous vs. intravenous access during out-of-hospital cardiac arrest: a Bayesian secondary analysis of a randomised clinical trial
Authors' conclusion
The probability of a clinically meaningful difference in return of spontaneous circulation between intraosseous and intravenous access for out-of-hospital cardiac arrest was very low, while results for 30-day outcomes were uncertain, with no strong evidence favouring either method.
Study context
- Population
- Adults with non-traumatic OHCA
- Participants
- 1,479 adults
- Comparison
- Intraosseous vs intravenous access
- Primary endpoint
- Posterior probabilities for sustained ROSC, 30-day survival and 30-day survival with favourable neurologic outcome
Methodological detailspre-planned Bayesian analyses, non-informative and informative priors
- Pre-planned Bayesian analyses
- Non-informative and informative priors
Primary result
As reported in the abstract
Sustained ROSC (non-informative priors)
Posterior probability RR > 1.27 (favouring intraosseous)
1.2%
Posterior probability RR < 0.79 [1/1.27] (favouring intravenous)
< 0.1%
Further findings
30-day survival
- Posterior probability RR intraosseous vs intravenous between 0.83 (1/1.2) and 1.2
- 58%
30-day survival with favourable neurologic outcome
- Posterior probability RR intraosseous vs intravenous between 0.83 (1/1.2) and 1.2
- 55%
All outcomes, informative priors
- No probabilities strongly favouring either intraosseous or intravenous access
Original publication
Intraosseous vs. intravenous access during out-of-hospital cardiac arrest: a Bayesian secondary analysis of a randomised clinical trial. Resuscitation. Published 17 May 2025. doi:10.
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