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[Out-of-hospital buffer therapy in heart arrest]
Insights
Buffer therapy did not improve outcomes for cardiac arrest patients. This study found no significant difference in hospital admission or survival rates between buffer and placebo groups during out-of-hospital cardiac arrest resuscitation efforts.
Area of Science:
- Emergency Medicine
- Critical Care Medicine
- Cardiology
Background:
- Out-of-hospital cardiac arrest (OHCA) frequently results in metabolic acidosis.
- The potential benefits of buffer solutions in improving resuscitation and patient outcomes remain under investigation.
Purpose of the Study:
- To evaluate the efficacy of buffer solution infusion on resuscitability and patient outcomes in adults experiencing OHCA.
- To determine if buffer therapy can mitigate metabolic acidosis and improve survival rates following cardiac arrest.
Main Methods:
- A prospective, randomized, double-blind, controlled trial involving 502 adult patients with ventricular fibrillation or asystole after failed defibrillation.
- Patients were assigned to receive either a buffer solution or a placebo (saline).
- Outcomes assessed included hospital admission and survival to discharge.
Main Results:
- Hospital admission rates were similar between the buffer group (36%) and the placebo group (36%).
- Survival to discharge was 10% in the buffer group compared to 14% in the placebo group.
- Metabolic acidosis was present in resuscitated patients, but buffer therapy did not demonstrate a significant improvement in outcomes.
Conclusions:
- Buffer therapy did not improve hospital admission or survival rates in patients with OHCA.
- While metabolic acidosis is common in OHCA survivors, buffer administration did not alter the overall outcome.
- Further research may be needed to explore alternative or adjunct therapies for metabolic acidosis in cardiac arrest scenarios.
Abstract:
The effects of infusing a buffer solution on resuscitability and outcome were tested in patients during out-of-hospital cardiac arrest. 502 adults with ventricular fibrillation or asystole with failure of first attempt at defibrillation were entered into a prospective, randomized, double-blind, controlled trial where one group received buffer and the other group placebo (saline). 87 of 245 (36%) patients who received a buffer were admitted to hospital and 24 (10%) were discharged alive, as against 92 of 257 (36%) admitted to hospital and 35 (14%) discharged alive for those who received placebo. Only 16 of the 502 patients had arterial alkalosis on arrival at hospital and no patient had a positive base excess. Patients resuscitated after out-of-hospital cardiac arrest had metabolic acidosis but buffer therapy did not improve outcome.