Experimental: IV yes
Intravenous needle Epinephrine q 3 min during CPR Atropine 3 mg in initial asystole Amiodarone 300 mg iv after repeated failed defibrillation attempts |
Drug: Epinephrine
Epinephrine 1 mg is given iv. every 3 min during CPR Device: Intravenous needle An intravenous needle in placed as soon as possible during CPR Drug: Atropine Atropine 3 mg iv in initial systole Other Name: Atropine sulfate Drug: Amiodarone amiodarone 300 mg iv after repeated failed defibrillation attempts |
No Intervention: IV no
The patient will not have an intravenous needle placed or given any drugs during CPR. If patient obtains spontaneous circulation, an intravenous needle is placed and patient can receive any drugs that are appropriate during the following treatment. |
Primary Outcome Measures :
- survival to hospital discharge with neurologic outcome [ Time Frame: discharge from hospital ]
Secondary Outcome Measures :
- admit to hospital with spontaneous circulation [ Time Frame: hospital admission ]
- one year survival with neurologic outcome [ Time Frame: one year after hospital discharge ]
Inclusion Criteria:
- Cardiac arrest out-of-hospital
Exclusion Criteria:
- <18 years old
- Trauma as cause of arrest
Norway | |
Ulleval University Hospital | |
Oslo, Norway, N-0407 |
Ullevaal University Hospital
Health Region East, Norway
Norwegian Air Ambulance Foundation
Principal Investigator: | Lars Wik, MD, PhD | Ullevaal University Hospital |
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Keywords provided by Petter Andreas Steen, University of Oslo:
Additional relevant MeSH terms:
Heart Arrest Heart Diseases Cardiovascular Diseases Atropine Amiodarone Epinephrine Adrenergic alpha-Agonists Adrenergic Agonists Adrenergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs Adrenergic beta-Agonists Bronchodilator Agents Autonomic Agents |
Peripheral Nervous System Agents Anti-Asthmatic Agents Respiratory System Agents Mydriatics Sympathomimetics Vasoconstrictor Agents Adjuvants, Anesthesia Anti-Arrhythmia Agents Parasympatholytics Muscarinic Antagonists Cholinergic Antagonists Cholinergic Agents Vasodilator Agents Potassium Channel Blockers Membrane Transport Modulators |
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From: Immediate intravenous epinephrine versus early intravenous epinephrine for in-hospital cardiopulmonary arrest
Median age in years (IQR) | 62 (26) | 62 (25.50) | 62 (25) | 0.90 |
Male n(%) | 220 (61.1%) | 113 (63.8%) | 107 (58.5%) | 0.29 |
Female n(%) | 140 (38.9%) | 64 (36.2%) | 76 (41.5%) | |
Saudi Arabian | 194 (53.9%) | 94 (53.1%) | 100 (54.6%) | 0.77 |
Non-Saudi | 166 (46.1%) | 83 (46.9%) | 83 (45.4%) | |
Median CPR duration in minutes (IQR) | 20:00 (16:45) | 16:00 (15:00) | 20:00 (15:00) | 0.70 |
Median epinephrine time in minutes (IQR) | 2:00 (3) | 0:00 (0) | 3:00 (3) | < 0.01 |
PEA n(%) | 132 (36.7%) | 95 (53.7%) | 37 (20.2%) | < 0.01 |
Asystole n(%) | 228 (63.3%) | 82 (46.3%) | 146 (79.8%) | |
Intubation during CPR n(%) | 199 (55.3%) | 94 (53.1%) | 105 (57.4%) | 0.41 |
No intubation during CPR n(%) | 161 (44.7%) | 83 (46.9%) | 78 (42.6%) | |
ROSC n(%) | 95 (26.4%) | 55 (31.1%) | 40 (21.9%) | 0.04 |
Respiratory n(%) | 132 (36.7%) | 53 (29.9%) | 79 (43.2%) | < 0.01 |
Cardiac n(%) | 95 (26.4%) | 60 (33.9%) | 35 (19.1%) | |
CNS n(%) | 48 (13.3%) | 22 (29.9%) | 26 (14.2%) | |
Metabolic n(%) | 43 (11.9%) | 26 (14.7%) | 17 (9.3%) | |
GI n(%) | 43 (11.7%) | 16 (9.0%) | 26 (14.2%) | |
ICU n(%) | 172 (47.8%) | 83 (46.9%) | 89 (48.6%) | 0.01 |
ED n(%) | 117 (32.5%) | 68 (38.4%) | 49 (26.8%) | |
Floor n(%) | 71 (19.7%) | 26 (14.7%) | 45 (24.6%) | |
Hospital A n(%) | 168 (46.7%) | 76 (42.9%) | 92 (50.3%) | 0.10 |
Hospital B n(%) | 98 (27.2%) | 46 (26.0%) | 52 (28.4%) | |
Hospital C n(%) | 94 (26.1%) | 55 (31.1%) | 39 (21.3%) |