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 for this work

Research output: Contribution to journal › Journal article › Research › peer-review

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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.

Original language	English
Journal	Resuscitation
Volume	175
Pages (from-to)	67-71
Number of pages	5
ISSN	0300-9572
DOIs	https://doi.org/10.1016/j.resuscitation.2022.04.017
Publication status	Published - Jun 2022

Bibliographical note

Keywords

In-hospital cardiac arrest
Long-term
Methylprednisolone
Outcomes
Vasopressin

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10.1016/j.resuscitation.2022.04.017Licence: CC BY 4.0

Granfeldt et al. (2022). Effect of vasopressin and methylprednisolone vs. placebo on long-term outcomes in patients with in-hospital cardiac arrest a randomized clinical trialFinal published version, 559 KBLicence: CC BY 4.0

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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., Rossau, J. R. G., 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. Advance online publication. https://doi.org/10.1016/j.resuscitation.2022.04.017

@article{2f4d42f17e144934a12b0c2f1b103f55,

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.",

keywords = "In-hospital cardiac arrest, Long-term, Methylprednisolone, Outcomes, Vasopressin",

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 Rossau, {J{\o}rgen R. G.} 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 Jepsen, {Rikke Malene H. G.} 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",

}

Granfeldt, A, Sindberg, B, Isbye, D, Kjærgaard, J, Kristensen, CM, Darling, S, Zwisler, ST, Fisker, S, Christian Schmidt, J, Kirkegaard, H, Grejs, AM, Rossau, JRG, 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, Jepsen, RMHG, 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, vol. 175, pp. 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 - Rossau, Jørgen R. G.

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 - Jepsen, Rikke Malene H. G.

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.

KW - In-hospital cardiac arrest

KW - Long-term

KW - Methylprednisolone

KW - Outcomes

KW - Vasopressin

UR - http://www.scopus.com/inward/record.url?scp=85129770063&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2022.04.017

DO - 10.1016/j.resuscitation.2022.04.017

M3 - Journal 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

Bibliographical note

Keywords

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