Can prehospital high-dose glucocorticoids impact hemodynamics in patients resuscitated from out-of-hospital cardiac arrest?
Recently published study is a sub-study of the STEROHCA trial and focuses on assessing the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose out-of-hospital cardiac arrest (OHCA) patients. The aim was to evaluate the association between inflammatory markers, hemodynamic instability, organ dysfunction, and the need for vasopressor support. The study included patients who remained comatose at admission and survived until intensive care unit (ICU) admission. The primary outcome was the cumulated norepinephrine use from ICU admission until 48 h reported as mcg/kg/min.
The STEROHCA trial was a phase 2 randomised study that compared the effects of a single prehospital injection of methylprednisolone 250 mg with a placebo given shortly after resuscitated out-of-hospital cardiac arrest. This sub-study included patients who were unconscious at arrival and survived until they were admitted to the intensive care unit (ICU). The main result was the total amount of norepinephrine used from ICU admission to 48 hours, recorded in mcg/kg/min. Secondary outcomes were assessing hemodynamic state using mean arterial pressure (MAP), heart rate, vasoactive-inotropic score (VIS), and the VIS/MAP-ratio, as well as evaluating cardiac function by pulmonary artery catheter measures. Linear mixed-model analyses were used to assess the mean differences between treatment groups at all follow-up dates.
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