VAM-IHCA

Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial

Anderson et al. JAMA 2021. doi:10.1001/jama.2021.16628

Clinical Question
-  In adult patients suffering an in-hospital cardiac arrest (IHCA) does the use of vasopressin and methylprednisolone compared to a placebo result in increased rates of return of spontaneous circulation (ROSC)?

N= 512, 10 hospitals in Denmark

Authors’ Conclusions
-  The administration of vasopressin and methylprednisolone, compared
to a placebo, significantly increased the likelihood of return of spontaneous circulation
-  Uncertainty remains as to whether this treatment results in long term survival benefit or harm

The Bottom Line
-  At present there is insufficient evidence to include the use of vasopressin and methylprednisolone as standard care in the management of IHCA
-  However, given the evidence base for the use of adrenaline in cardiac arrest algorithms it will be interesting to see the recommendations of expert committees if further trials demonstrate a survival benefit