6/30/23, 12:10 AM VAM-IHCA Pathway Feedback Search Clinical Topics Home Studies VAM IHCA VAM IHCA Disease Cardiac arrest Trial question What is the effect of vasopressin and methylprednisolone in patients with in-hospital cardiac arrest? Study design Multi-center Double blinded RCT Population Characteristics of study participants 36.0% female N = 501 64.0% male 501 patients (179 female, 322 male) Inclusion criteria: adult patients with in-hospital cardiac arrest who received at least 1 dose of epinephrine during cardiac arrest Key exclusion criteria: do-not-resuscitate order, prior enrollment in the trial, invasive mechanical circulatory support, pregnancy Interventions N=237 vasopressin and methylprednisolone (20 units of vasopressin with 40 mg methylprednisolone) N=264 placebo (sodium chloride solution) Primary outcome Return of spontaneous circulation 42.0 % 42 https://web.pathway.md/studies/recvTiNn7q3ESOfdJ 1/2 6/30/23, 12:10 AM VAM-IHCA Pathway 33 31.5 % 21.0 % Significant increase 10.5 % NNH = 11 0.0 % Vasopressin and methylprednisolone Placebo Significant increase in ROSC (42% vs. 33%; RR 1.3, 95% CI 1.03 to 1.63) Secondary outcomes No significant difference in survival at day 30 (9.7% vs. 12%; RR 0.83, 95% CI 0.5 to 1.37) No significant difference in favorable neurologic outcome at day 30 (7.6% vs. 7.6%; RR 1, 95% CI 0.55 to 1.83) No significant difference in survival at day 90 (8.4% vs. 9.1%; RR 0.93, 95% CI 0.53 to 1.62) Safety outcomes No significant differences in hyperglycemia, hypernatremia. Conclusion In adult patients with in-hospital cardiac arrest who received at least 1 dose of epinephrine during cardiac arrest, vasopressin and methylprednisolone were superior to placebo with respect to ROSC. Reference Lars W Andersen, Dan Isbye, Jesper Kj rgaard et al. Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In- Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2021 Oct 26;326(16):1586-1594. Open reference URL https://web.pathway.md/studies/recvTiNn7q3ESOfdJ 2/2