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Augmented-Medication CardioPulmonary Resuscitation (AMCPR) trial: a study protocol for a randomized controlled trial
Dong Kun Oh1, June-Sung Kim1, Seung Mok Ryoo1
1Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Clinical and Experimental Emergency Medicine
|November 1, 2022
Summary
Augmented-Medication Cardiopulmonary Resuscitation (AMCPR) using vasopressin with epinephrine may improve return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest patients. This trial investigates AMCPR
Area of Science:
- Emergency Medicine
- Cardiology
- Critical Care Medicine
Background:
- Clinical trials on hemodynamic-directed cardiopulmonary resuscitation are limited.
- Out-of-hospital cardiac arrest (OHCA) remains a critical medical emergency with low survival rates.
- Optimizing resuscitation strategies is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the efficacy of Augmented-Medication Cardiopulmonary Resuscitation (AMCPR) in improving return of spontaneous circulation (ROSC).
- To evaluate the impact of vasopressin combined with epinephrine on hemodynamic parameters during resuscitation.
- To identify patient subgroups who may benefit from AMCPR in OHCA settings.
Main Methods:
- A double-blind, single-center, randomized placebo-controlled trial involving 148 adult patients with OHCA.
- Patients received either intravenous vasopressin (40 IU) with epinephrine or a placebo with epinephrine.
- Primary endpoint was sustained ROSC; secondary endpoints included hemodynamic and biochemical markers.
Main Results:
- The study aimed to assess the primary endpoint of sustained ROSC (over 20 minutes).
- Secondary endpoints included improvements in diastolic blood pressure, end-tidal carbon dioxide, acidosis, and lactate levels.
- Results will provide evidence on the effectiveness of vasopressin and epinephrine in enhancing ROSC rates.
Conclusions:
- AMCPR represents a tailored medication approach for select patients during resuscitation.
- This is the first randomized controlled trial to assess vasopressin's benefit for ROSC in OHCA.
- The study will offer critical evidence regarding the administration of vasopressin with epinephrine to increase ROSC rates.
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