Cardiac arrest & resuscitation
The Effect of Time to Treatment With Antiarrhythmic Drugs on Survival and Neurological Outcomes in Shock Refractory Out-of-Hospital Cardiac Arrest
Authors' conclusion
Survival and favorable neurologic outcomes decreased with longer times to drug administration. Amiodarone improved survival at all time points whereas lidocaine improved survival only at later time points, compared with placebo.
Study context
- Population
- Adults with nontraumatic out-of-hospital cardiac arrest (OHCA) and initial VF or pulseless VT refractory to ≥1 defibrillation attempt, multiple North American EMS sites2,994 with time data
- Participants
- 3,026 adults
- Comparison
- Association of time to treatment with outcomes; amiodarone or lidocaine vs placebo
- Primary endpoint
- Survival to hospital discharge by time to treatment (drug or placebo)
Methodological detailspost hoc analysis, multicentre
- Post hoc analysis
- Multicentre
Primary result
As reported in the abstract
Survival to hospital discharge per min of time to drug administration
| Group | OR per min | OR |
|---|---|---|
| Amiodarone | 0.91 (95% CI 0.90-0.93) | |
| Lidocaine | 0.93 (95% CI 0.91-0.96) | |
| Placebo | 0.91 (95% CI 0.90-0.93) |
OR per min
Amiodarone0.91 (95% CI 0.90-0.93)
Lidocaine— not stated in the abstract
Placebo— not stated in the abstract
OR
Amiodarone— not stated in the abstract
Lidocaine0.93 (95% CI 0.91-0.96)
Placebo0.91 (95% CI 0.90-0.93)
Further findings
| Outcome | OR for survival to hospital discharge (95% CI) | |
|---|---|---|
| Survival to hospital discharge, amiodarone vs placebo · all times of drug administrationImproved survival at all times of drug administration | 1.32 (1.05–1.65) | |
| 0.512OR for survival to hospital discharge (log scale) |
Survival to hospital discharge, lidocaine vs placebo by time to drug administration
- Survival not different with shorter times to drug administration (< 11 min); higher with lidocaine at longer times
- Interaction between treatment effect and time to treatment p = 0.048
Survival with good neurologic outcome (modified Rankin Scale ≤ 3 at discharge)
- Similar results for all analyses
Original publication
The Effect of Time to Treatment With Antiarrhythmic Drugs on Survival and Neurological Outcomes in Shock Refractory Out-of-Hospital Cardiac Arrest. Crit Care Med. Published 4 April 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →