RecruitingNot ApplicableNCT06203847

The Effect of Prehospital Combination of Epinephrine, Vasopressin, and Steroid in OHCA

A Randomized Clinical Trial of Patient Outcomes Following Out-of-Hospital Cardiac Arrest Receiving Epinephrine Versus In-together Vasopressin, Epinephrine, and Steroid. (OHCA REVIVES Trial)

Sponsor

National Taiwan University Hospital

Enrollment

1,344 participants

Start Date

Jul 16, 2024

Study Type

INTERVENTIONAL

Conditions

Cardiac Arrest Out-of-hospital cardiac arrest Emergency Medical Services

Summary

This project is a randomized controlled clinical research design, The hypothesis P-I-C-O of the study is: For adult patients in the Taipei City and New Taipei City communities who have suffered sudden non-traumatic death and have been resuscitated by advanced paramedics, the intervention group that receives combined drug treatment (epinephrine, vasopressin, methylprednisolone) has a better rate of sustained recovery of spontaneous circulation (ROSC) (primary outcome) and long-term survival status (secondary outcomes) compared to the control group that receives single drug treatment (epinephrine).

Eligibility

Min Age: 18 Years

Inclusion Criteria3

Adult patients (aged >= 18 )
Out-of-hospital cardiac arrest in the studied regions
Treated by paramedics authorized and capable of giving prehospital medication

Exclusion Criteria8

OHCA with traumatic etiology
Obvious signs of death like decapitation, rigor mortis, livor mortis, decomposition, etc.
DNR (Do Not Resuscitation) or termination of resuscitation requested by the family
Patients with known or suspected pregnancy
No vascular access was established before hospital arrival
ROSC before the administrated medication
No patient contact (cancelled ambulance call or the patient was transported to the hospital before the arrival of trial-trained paramedics)
Received epinephrine prior to the arrival of trial-trained paramedics

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Interventions

DRUGCombination group

Combination of epinephrine (Adrenaline® 1mg/vial) every 3-5 minutes, vasopressin (Pitressin® 20Unints/vial) every 3-5 minutes up to 4 vials (a total of 80Units), methylprednisolone (Solu-Medrol® 40mg/vial)

DRUGStandard group

standard doses of epinephrine (Adrenaline® 1mg/vial) every 3-5 minutes