Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest

Patel, Jayshil J.

doi:10.1056/nejmoa1514204

Cited by 369 publications

(318 citation statements)

References 23 publications

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“…The investigators evaluated 3,026 patients, of whom 974 were assigned to the amiodarone group, 993 to the lidocaine group, and 1,059 to the placebo group. Of these patients, 24.4%, 23.7%, and 21.0%, Kudenchuk et al [8] concluded the ROC-ALPS study as follows: neither amiodarone nor lidocaine resulted in a survival rate or favorable neurological outcome that was significantly better than that achieved with placebo among patients with OHCA due to initial shock-refractory VF/ pVT. However, the study also provided insightful data to the field of resuscitation.…”

Section: The Roc-alps Studymentioning

confidence: 99%

“…After publication of the results of the ROC-ALPS study, several corresponding editorials and comments were published in response [35][36][37][38]. As pointed out by several comments, the key finding of the ROC-ALPS study was that both amiodarone and lidocaine therapies may be effective for shock-refractory VF/pVT in bystander-witnessed arrest but might be useless in the later phase of resuscitation [35,37].…”

Section: Is Earlier Provision Of Antiarrhythmic Drugs Better?mentioning

confidence: 99%

“…In a trial involving OHCA patients with VF/pVT, Dorian et al [7] reported that the rate of survival to admission was significantly higher in the amiodarone group than in the lidocaine group but found no significant difference in the rate of survival to discharge between the two groups. More recently, Kudenchuk et al [8] reported survival data for patients with OHCA due to initial VF/ pVT in the prehospital setting and found that survival rates with amiodarone or lidocaine administration were not significantly higher than with placebo.…”

mentioning

confidence: 99%

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Antiarrhythmic Drugs for Out-of-Hospital Cardiac Arrest with Refractory Ventricular Fibrillation

Tagami¹,

Yasunaga²

2017

Annual Update in Intensive Care and Emergency Medicine

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Section: The Roc-alps Studymentioning

confidence: 99%

Section: Is Earlier Provision Of Antiarrhythmic Drugs Better?mentioning

confidence: 99%

mentioning

confidence: 99%

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Antiarrhythmic Drugs for Out-of-Hospital Cardiac Arrest with Refractory Ventricular Fibrillation

Tagami¹,

Yasunaga²

2017

Annual Update in Intensive Care and Emergency Medicine

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“…usporedili parenteralni amiodaron, lidokain i placebo primjenom fiziološke otopine, zajedno sa standardnim pristupom, u odraslih s izvanbolničkim srčanim zastojem, ventrikularnom fibrilacijom rezistentnom na primjenu elektrošoka ili VT-om bez pulsa nakon barem jednog elektrošoka. 34 Od 3026 uključenih pacijentata 974 su randomizirana na amiodaron, 993 na lidokain i 1059 na placebo. Nisu registrirane razlike u preživljenju do otpusta iz bolnice (24 %, 24 % i 21 %) ili u neurološkom ishodu između triju skupina.…”

Section: Ventricular Arrhythmias and Sudden Cardiac Deathunclassified

“…Potrebne su daljnje studije koje će istražiti zaštitni učinak liječenja ugradnjom ICD uređaja u bolesnika u kojih je dijagnoza neishemijske kardiomiopatije postavljena u mladoj dobi i u kojih je indikacija za primarnu profilaksu postavljena u relativno kratkom vremenskom inIn a recent study, Kudenchuck et al compared parenteral amiodarone, lidocaine, and saline placebo, along with standard of care, in adults with out-of-hospital cardiac arrest, shock refractory ventricular fibrillation (VF) or pulseless VT after at least one shock. 34 Of 3026 enrolled patients, 974 were assigned to amiodarone, 993 to lidocaine and 1059 to placebo. No differences in survival to hospital discharge (24%, 24% and 21%, respectively) or neurologic outcome were found among the three groups.…”

Section: Srčani Elektronički Uređaji Liječenje Implantabilnim Kardiovmentioning

confidence: 99%

The year in cardiology 2016: arrhythmias and cardiac implantable electronic devices

Cappato¹,

Hindricks

Steffel

2017

Cardiologia Croatica

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In-Hospital Cardiac Arrest

Andersen

Holmberg

Berg

et al. 2019

JAMA

675

535

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IMPORTANCE In-hospital cardiac arrest is common and associated with a high mortality rate. Despite this, in-hospital cardiac arrest has received little attention compared with other high-risk cardiovascular conditions, such as stroke, myocardial infarction, and out-of-hospital cardiac arrest. OBSERVATIONS In-hospital cardiac arrest occurs in over 290 000 adults each year in the United States. Cohort data from the United States indicate that the mean age of patients with in-hospital cardiac arrest is 66 years, 58% are men, and the presenting rhythm is most often (81%) nonshockable (ie, asystole or pulseless electrical activity). The cause of the cardiac arrest is most often cardiac (50%-60%), followed by respiratory insufficiency (15%-40%). Efforts to prevent in-hospital cardiac arrest require both a system for identifying deteriorating patients and an appropriate interventional response (eg, rapid response teams). The key elements of treatment during cardiac arrest include chest compressions, ventilation, early defibrillation, when applicable, and immediate attention to potentially reversible causes, such as hyperkalemia or hypoxia. There is limited evidence to support more advanced treatments. Post–cardiac arrest care is focused on identification and treatment of the underlying cause, hemodynamic and respiratory support, and potentially employing neuroprotective strategies (eg, targeted temperature management). Although multiple individual factors are associated with outcomes (eg, age, initial rhythm, duration of the cardiac arrest), a multifaceted approach considering both potential for neurological recovery and ongoing multiorgan failure is warranted for prognostication and clinical decision-making in the Post–cardiac arrest period. Withdrawal of care in the absence of definite prognostic signs both during and after cardiac arrest should be avoided. Hospitals are encouraged to participate in national quality-improvement initiatives. CONCLUSIONS AND RELEVANCE An estimated 290 000 in-hospital cardiac arrests occur each year in the United States. However, there is limited evidence to support clinical decision making. An increased awareness with regard to optimizing clinical care and new research might improve outcomes.

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Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest

Cited by 369 publications

References 23 publications

Antiarrhythmic Drugs for Out-of-Hospital Cardiac Arrest with Refractory Ventricular Fibrillation

Antiarrhythmic Drugs for Out-of-Hospital Cardiac Arrest with Refractory Ventricular Fibrillation

The year in cardiology 2016: arrhythmias and cardiac implantable electronic devices

In-Hospital Cardiac Arrest

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