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Calcium use during cardiac arrest: A systematic review
Eduardo Messias Hirano Padrao1, Brian Bustos1, Ashwin Mahesh1
1Department of Medicine, University of Connecticut, Farmington, CT, USA.
Resuscitation Plus
|October 14, 2022
Summary
Calcium administration during cardiac arrest offers no survival benefit and may lead to harm. This systematic review found no positive impact on return of spontaneous circulation or survival rates.
Area of Science:
- Cardiology
- Emergency Medicine
- Clinical Research
Background:
- The efficacy of calcium administration during cardiac arrest remains controversial.
- Conflicting evidence necessitates a comprehensive review of its role.
Purpose of the Study:
- To systematically evaluate the impact of calcium administration on patient outcomes during cardiac arrest.
- To synthesize evidence regarding calcium's role in return of spontaneous circulation and survival.
Main Methods:
- A systematic review and meta-analysis of studies comparing calcium versus no calcium in cardiac arrest.
- Searched PubMed, Cochrane, and EMBASE databases; prospectively registered on PROSPERO.
- Assessed risk of bias using RoB-2 and ROBINS-I tools.
Main Results:
- Ten studies with 2509 patients were included; meta-analysis of low-bias studies was not feasible.
- No significant benefit of calcium for return of spontaneous circulation (ROSC) was observed in three RCTs.
- Neutral effect on survival to discharge/30 days and 30-day neurological outcomes; unfavorable 90-day neurological outcomes noted.
Conclusions:
- Calcium administration in cardiac arrest does not improve outcomes and may be detrimental.
- Current evidence suggests calcium should not be administered during cardiac arrest.
- Further research in this area is likely unwarranted due to lack of benefit and potential harm.
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