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Administration of calcium does not improve outcomes during out-of-hospital cardiac arrest: JAMA

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-12-02T10:45:29+05:30  |  Updated On 2 Dec 2021 2:48 PM IST
Administration of calcium does not improve outcomes during out-of-hospital cardiac arrest: JAMA
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Administration of calcium does not improve outcomes during out-of-hospital cardiac arrest in adults, according to a recent study published in the JAMA Cardiology.

It is unclear whether the administration of calcium has a beneficial effect in patients with cardiac arrest. A group of researchers conducted a study to determine whether the administration of calcium during out-of-hospital cardiac arrest improves return of spontaneous circulation in adults. This double-blind, placebo-controlled randomized clinical trial included 397 adult patients with out-of-hospital cardiac arrest and was conducted in the Central Denmark Region between January 20, 2020, and April 15, 2021. The last 90-day follow-up was on July 15, 2021. The intervention consisted of up to 2 intravenous or intraosseous doses with 5 mmol of calcium chloride (n = 197) or saline (n = 200). The first dose was administered immediately after the first dose of epinephrine. The primary outcome was sustained return of spontaneous circulation. The secondary outcomes included survival and a favorable neurological outcome (modified Rankin Scale score of 0-3) at 30 days and 90 days.

The Results of the study are as follows:

Based on a planned interim analysis of 383 patients, the steering committee stopped the trial early due to concerns about harm in the calcium group. Of 397 adult patients randomized, 391 were included in the analyses (193 in the calcium group and 198 in the saline group; mean age, 68 [SD, 14] years; 114 [29%] were female). There was no loss to follow-up. There were 37 patients (19%) in the calcium group who had sustained return of spontaneous circulation compared with 53 patients (27%) in the saline group (risk ratio, 0.72 [95% CI, 0.49 to 1.03]; risk difference, −7.6% [95% CI, −16% to 0.8%]; P = .09). At 30 days, 10 patients (5.2%) in the calcium group and 18 patients (9.1%) in the saline group were alive (risk ratio, 0.57 [95% CI, 0.27 to 1.18]; risk difference, −3.9% [95% CI, −9.4% to 1.3%]; P = .17). A favorable neurological outcome at 30 days was observed in 7 patients (3.6%) in the calcium group and in 15 patients (7.6%) in the saline group (risk ratio, 0.48 [95% CI, 0.20 to 1.12]; risk difference, −4.0% [95% CI, −8.9% to 0.7%]; P = .12). Among the patients with calcium values measured who had a return of spontaneous circulation, 26 (74%) in the calcium group and 1 (2%) in the saline group had hypercalcemia.

Thus, the researchers concluded that among adults with out-of-hospital cardiac arrest, treatment with intravenous or intraosseous calcium compared with saline did not significantly improve the sustained return of spontaneous circulation. These results do not support the administration of calcium during out-of-hospital cardiac arrest in adults

Reference:

Effect of Intravenous or Intraosseous Calcium vs Saline on Return of Spontaneous Circulation in Adults with Out-of-Hospital Cardiac Arrest A Randomized Clinical Trial by Mikael Fink Vallentin et al., published in the JAMA Cardiology.

https://jamanetwork.com/journals/jama/fullarticle/2786819?guestAccessKey=d8224c9e-b951-4871-bb43-35e186d501a8&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=113021



intravenous Calciumintraosseous calciumIntraosseous salineintravenous salinespontaneous circulationout-of-hospital cardiac arrestadultsjama cardiology
Source : JAMA Cardiology
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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