Effect of Vasopressin and Methylprednisolone vs. Placebo on Long-Term Outcomes in Patients with In-Hospital Cardiac Arrest A Randomized Clinical Trial

Asger Granfeldt; Birthe Sindberg; Dan Isbye; Jesper Kjærgaard; Camilla M Kristensen; Søren Darling; Stine T Zwisler; Stine Fisker; Jens Christian Schmidt; Hans Kirkegaard; Anders M Grejs; Jørgen R G Rossau; Jacob M Larsen; Bodil S Rasmussen; Signe Riddersholm; Kasper Iversen; Martin Schultz; Jakob L Nielsen; Bo Løfgren; Kasper G Lauridsen; Christoffer Sølling; Kim Pælestik; Anders G Kjærgaard; Dorte Due-Rasmussen; Fredrik Folke; Mette G Charlot; Rikke Malene H G Jepsen; Sebastian Wiberg; Maria Høybye; Mathias J Holmberg; Lars W Andersen

doi:10.1016/j.resuscitation.2022.04.017

Effect of Vasopressin and Methylprednisolone vs. Placebo on Long-Term Outcomes in Patients with In-Hospital Cardiac Arrest A Randomized Clinical Trial

Asger Granfeldt, Birthe Sindberg, Dan Isbye, Jesper Kjærgaard, Camilla M Kristensen, Søren Darling, Stine T Zwisler, Stine Fisker, Jens Christian Schmidt, Hans Kirkegaard, Anders M Grejs, Jørgen R G Rossau, Jacob M Larsen, Bodil S Rasmussen, Signe Riddersholm, Kasper Iversen, Martin Schultz, Jakob L Nielsen, Bo Løfgren, Kasper G LauridsenChristoffer Sølling, Kim Pælestik, Anders G Kjærgaard, Dorte Due-Rasmussen, Fredrik Folke, Mette G Charlot, Rikke Malene H G Jepsen, Sebastian Wiberg, Maria Høybye, Mathias J Holmberg, Lars W Andersen^*

^*Corresponding author af dette arbejde

Anæstesiologisk Afdeling

Publikation: Bidrag til tidsskrift › Artikel › Forskning › peer review

Abstract

OBJECTIVE: The primary results from the Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest (VAM-IHCA) trial have previously been reported. The objective of the current manuscript is to report long-term outcomes.

METHODS: The VAM-IHCA trial was a multicenter, randomized, double-blind, placebo-controlled trial conducted at ten hospitals in Denmark. Adult patients (age ≥ 18 years) were eligible for the trial if they had an in-hospital cardiac arrest and received at least one dose of epinephrine during resuscitation. The trial drugs consisted of 40 mg methylprednisolone (Solu-Medrol®, Pfizer) and 20 IU of vasopressin (Empressin®, Amomed Pharma GmbH) given as soon as possible after the first dose of epinephrine. This manuscript report outcomes at 6 months and 1 year including survival, survival with favorable neurological outcome, and health-related quality of life.

RESULTS: 501 patients were included in the analysis. At 1 year, 15 patients (6.3%) in the intervention group and 22 patients (8.3%) in the placebo group were alive corresponding to a risk ratio of 0.76 (95% CI, 0.41-1.41). A favorable neurologic outcome at 1 year, based on the Cerebral Performance Category score, was observed in 14 patients (5.9%) in the intervention group and 20 patients (7.6%) in the placebo group (risk ratio, 0.78 [95% CI, 0.41-1.49]. No differences existed between groups for favorable neurological outcome and health-related quality of life at either 6 months or 1 year.

CONCLUSIONS: Administration of vasopressin and methylprednisolone, compared with placebo, in patients with in-hospital cardiac arrest did not improve long-term outcomes in this trial.

Originalsprog	Engelsk
Sider (fra-til)	67-71
Antal sider	5
Tidsskrift	Resuscitation
Vol/bind	175
Tidlig onlinedato	28 apr. 2022
DOI	https://doi.org/10.1016/j.resuscitation.2022.04.017
Status	Udgivet - jun. 2022

Bibliografisk note

Adgang til dokumentet

10.1016/j.resuscitation.2022.04.017Licens: CC BY

Citationsformater

Granfeldt, A., Sindberg, B., Isbye, D., Kjærgaard, J., Kristensen, C. M., Darling, S., Zwisler, S. T., Fisker, S., Christian Schmidt, J., Kirkegaard, H., Grejs, A. M., R G Rossau, J., Larsen, J. M., Rasmussen, B. S., Riddersholm, S., Iversen, K., Schultz, M., Nielsen, J. L., Løfgren, B., ... Andersen, L. W. (2022). Effect of Vasopressin and Methylprednisolone vs. Placebo on Long-Term Outcomes in Patients with In-Hospital Cardiac Arrest A Randomized Clinical Trial. Resuscitation, 175, 67-71. https://doi.org/10.1016/j.resuscitation.2022.04.017

@article{78ead0040f534a30891e5d255ee38a71,

title = "Effect of Vasopressin and Methylprednisolone vs. Placebo on Long-Term Outcomes in Patients with In-Hospital Cardiac Arrest A Randomized Clinical Trial",

abstract = "OBJECTIVE: The primary results from the Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest (VAM-IHCA) trial have previously been reported. The objective of the current manuscript is to report long-term outcomes.METHODS: The VAM-IHCA trial was a multicenter, randomized, double-blind, placebo-controlled trial conducted at ten hospitals in Denmark. Adult patients (age ≥ 18 years) were eligible for the trial if they had an in-hospital cardiac arrest and received at least one dose of epinephrine during resuscitation. The trial drugs consisted of 40 mg methylprednisolone (Solu-Medrol{\textregistered}, Pfizer) and 20 IU of vasopressin (Empressin{\textregistered}, Amomed Pharma GmbH) given as soon as possible after the first dose of epinephrine. This manuscript report outcomes at 6 months and 1 year including survival, survival with favorable neurological outcome, and health-related quality of life.RESULTS: 501 patients were included in the analysis. At 1 year, 15 patients (6.3%) in the intervention group and 22 patients (8.3%) in the placebo group were alive corresponding to a risk ratio of 0.76 (95% CI, 0.41-1.41). A favorable neurologic outcome at 1 year, based on the Cerebral Performance Category score, was observed in 14 patients (5.9%) in the intervention group and 20 patients (7.6%) in the placebo group (risk ratio, 0.78 [95% CI, 0.41-1.49]. No differences existed between groups for favorable neurological outcome and health-related quality of life at either 6 months or 1 year.CONCLUSIONS: Administration of vasopressin and methylprednisolone, compared with placebo, in patients with in-hospital cardiac arrest did not improve long-term outcomes in this trial.",

author = "Asger Granfeldt and Birthe Sindberg and Dan Isbye and Jesper Kj{\ae}rgaard and Kristensen, {Camilla M} and S{\o}ren Darling and Zwisler, {Stine T} and Stine Fisker and {Christian Schmidt}, Jens and Hans Kirkegaard and Grejs, {Anders M} and {R G Rossau}, J{\o}rgen and Larsen, {Jacob M} and Rasmussen, {Bodil S} and Signe Riddersholm and Kasper Iversen and Martin Schultz and Nielsen, {Jakob L} and Bo L{\o}fgren and Lauridsen, {Kasper G} and Christoffer S{\o}lling and Kim P{\ae}lestik and Kj{\ae}rgaard, {Anders G} and Dorte Due-Rasmussen and Fredrik Folke and Charlot, {Mette G} and {Malene H G Jepsen}, Rikke and Sebastian Wiberg and Maria H{\o}ybye and Holmberg, {Mathias J} and Andersen, {Lars W}",

year = "2022",

month = jun,

doi = "10.1016/j.resuscitation.2022.04.017",

language = "English",

volume = "175",

pages = "67--71",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier Ireland Ltd",

}

Granfeldt, A, Sindberg, B, Isbye, D, Kjærgaard, J, Kristensen, CM, Darling, S, Zwisler, ST, Fisker, S, Christian Schmidt, J, Kirkegaard, H, Grejs, AM, R G Rossau, J, Larsen, JM, Rasmussen, BS, Riddersholm, S, Iversen, K, Schultz, M, Nielsen, JL, Løfgren, B, Lauridsen, KG, Sølling, C, Pælestik, K, Kjærgaard, AG, Due-Rasmussen, D, Folke, F, Charlot, MG, Malene H G Jepsen, R, Wiberg, S, Høybye, M, Holmberg, MJ & Andersen, LW 2022, 'Effect of Vasopressin and Methylprednisolone vs. Placebo on Long-Term Outcomes in Patients with In-Hospital Cardiac Arrest A Randomized Clinical Trial', Resuscitation, bind 175, s. 67-71. https://doi.org/10.1016/j.resuscitation.2022.04.017

TY - JOUR

T1 - Effect of Vasopressin and Methylprednisolone vs. Placebo on Long-Term Outcomes in Patients with In-Hospital Cardiac Arrest A Randomized Clinical Trial

AU - Granfeldt, Asger

AU - Sindberg, Birthe

AU - Isbye, Dan

AU - Kjærgaard, Jesper

AU - Kristensen, Camilla M

AU - Darling, Søren

AU - Zwisler, Stine T

AU - Fisker, Stine

AU - Christian Schmidt, Jens

AU - Kirkegaard, Hans

AU - Grejs, Anders M

AU - R G Rossau, Jørgen

AU - Larsen, Jacob M

AU - Rasmussen, Bodil S

AU - Riddersholm, Signe

AU - Iversen, Kasper

AU - Schultz, Martin

AU - Nielsen, Jakob L

AU - Løfgren, Bo

AU - Lauridsen, Kasper G

AU - Sølling, Christoffer

AU - Pælestik, Kim

AU - Kjærgaard, Anders G

AU - Due-Rasmussen, Dorte

AU - Folke, Fredrik

AU - Charlot, Mette G

AU - Malene H G Jepsen, Rikke

AU - Wiberg, Sebastian

AU - Høybye, Maria

AU - Holmberg, Mathias J

AU - Andersen, Lars W

PY - 2022/6

Y1 - 2022/6

N2 - OBJECTIVE: The primary results from the Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest (VAM-IHCA) trial have previously been reported. The objective of the current manuscript is to report long-term outcomes.METHODS: The VAM-IHCA trial was a multicenter, randomized, double-blind, placebo-controlled trial conducted at ten hospitals in Denmark. Adult patients (age ≥ 18 years) were eligible for the trial if they had an in-hospital cardiac arrest and received at least one dose of epinephrine during resuscitation. The trial drugs consisted of 40 mg methylprednisolone (Solu-Medrol®, Pfizer) and 20 IU of vasopressin (Empressin®, Amomed Pharma GmbH) given as soon as possible after the first dose of epinephrine. This manuscript report outcomes at 6 months and 1 year including survival, survival with favorable neurological outcome, and health-related quality of life.RESULTS: 501 patients were included in the analysis. At 1 year, 15 patients (6.3%) in the intervention group and 22 patients (8.3%) in the placebo group were alive corresponding to a risk ratio of 0.76 (95% CI, 0.41-1.41). A favorable neurologic outcome at 1 year, based on the Cerebral Performance Category score, was observed in 14 patients (5.9%) in the intervention group and 20 patients (7.6%) in the placebo group (risk ratio, 0.78 [95% CI, 0.41-1.49]. No differences existed between groups for favorable neurological outcome and health-related quality of life at either 6 months or 1 year.CONCLUSIONS: Administration of vasopressin and methylprednisolone, compared with placebo, in patients with in-hospital cardiac arrest did not improve long-term outcomes in this trial.

AB - OBJECTIVE: The primary results from the Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest (VAM-IHCA) trial have previously been reported. The objective of the current manuscript is to report long-term outcomes.METHODS: The VAM-IHCA trial was a multicenter, randomized, double-blind, placebo-controlled trial conducted at ten hospitals in Denmark. Adult patients (age ≥ 18 years) were eligible for the trial if they had an in-hospital cardiac arrest and received at least one dose of epinephrine during resuscitation. The trial drugs consisted of 40 mg methylprednisolone (Solu-Medrol®, Pfizer) and 20 IU of vasopressin (Empressin®, Amomed Pharma GmbH) given as soon as possible after the first dose of epinephrine. This manuscript report outcomes at 6 months and 1 year including survival, survival with favorable neurological outcome, and health-related quality of life.RESULTS: 501 patients were included in the analysis. At 1 year, 15 patients (6.3%) in the intervention group and 22 patients (8.3%) in the placebo group were alive corresponding to a risk ratio of 0.76 (95% CI, 0.41-1.41). A favorable neurologic outcome at 1 year, based on the Cerebral Performance Category score, was observed in 14 patients (5.9%) in the intervention group and 20 patients (7.6%) in the placebo group (risk ratio, 0.78 [95% CI, 0.41-1.49]. No differences existed between groups for favorable neurological outcome and health-related quality of life at either 6 months or 1 year.CONCLUSIONS: Administration of vasopressin and methylprednisolone, compared with placebo, in patients with in-hospital cardiac arrest did not improve long-term outcomes in this trial.

U2 - 10.1016/j.resuscitation.2022.04.017

DO - 10.1016/j.resuscitation.2022.04.017

M3 - Article

C2 - 35490936

SN - 0300-9572

VL - 175

SP - 67

EP - 71

JO - Resuscitation

JF - Resuscitation

ER -

Effect of Vasopressin and Methylprednisolone vs. Placebo on Long-Term Outcomes in Patients with In-Hospital Cardiac Arrest A Randomized Clinical Trial

Abstract

Bibliografisk note

Adgang til dokumentet

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