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

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

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 languageEnglish
JournalResuscitation
Volume175
Pages (from-to)67-71
Number of pages5
ISSN0300-9572
DOIs
Publication statusPublished - Jun 2022

    Research areas

  • In-hospital cardiac arrest, Long-term, Methylprednisolone, Outcomes, Vasopressin

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