Intravenous vs. intraosseous vascular access during out-of-hospital cardiac arrest - protocol for a randomised clinical trial.

Autor:	Meilandt C; Prehospital Emergency Medical Services, Central Denmark Region, Denmark., Fink Vallentin M; Prehospital Emergency Medical Services, Central Denmark Region, Denmark., Blumensaadt Winther K; Prehospital Emergency Medical Services, Central Denmark Region, Denmark., Bach A; Prehospital Emergency Medical Services, Central Denmark Region, Denmark., Dissing TH; Prehospital Emergency Medical Services, Central Denmark Region, Denmark.; Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Denmark., Christensen S; Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Denmark.; Department of Clinical Medicine, Aarhus University, Denmark., Juhl Terkelsen C; Department of Cardiology, Aarhus University Hospital, Denmark., Lass Klitgaard T; Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Denmark., Mikkelsen S; The Prehospital Research Unit, Region of Southern Denmark, Denmark., Folke F; Copenhagen Emergency Medical Services, Capital Region of Denmark, Denmark.; Department of Cardiology, Herlev Gentofte University Hospital, Denmark.; Department of Clinical Medicine, University of Copenhagen, Denmark., Granfeldt A; Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Denmark.; Department of Clinical Medicine, Aarhus University, Denmark., Andersen LW; Prehospital Emergency Medical Services, Central Denmark Region, Denmark.; Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Denmark.; Department of Clinical Medicine, Aarhus University, Denmark.; Department of Anesthesiology and Intensive Care, Viborg Regional Hospital, Viborg, Denmark.
Jazyk:	angličtina
Zdroj:	Resuscitation plus [Resusc Plus] 2023 Jul 14; Vol. 15, pp. 100428. Date of Electronic Publication: 2023 Jul 14 (Print Publication: 2023).
DOI:	10.1016/j.resplu.2023.100428
Abstrakt:	Objective: During cardiac arrest, current guidelines recommend attempting intravenous access first and to consider intraosseous access if intravenous access is unsuccessful or impossible. However, these recommendations are only based on very low-certainty evidence. Therefore, the "Intravenous vs Intraosseous Vascular Access During Out-of-Hospital Cardiac Arrest" (IVIO) trial aims to determine whether there is a difference in patient outcomes depending on the type of vascular access attempted during out-of-hospital cardiac arrest. This current article describes the clinical IVIO trial. Methods: The IVIO trial is an investigator-initiated, randomised trial of intravenous vs. intraosseous vascular access during adult non-traumatic out-of-hospital cardiac arrest in Denmark. The intervention will consist of minimum two attempts (if unsuccessful on the first attempt) to successfully establish intravenous or intraosseous vascular access during cardiac arrest. The intraosseous group will be further randomised to the humeral or tibial site. The primary outcome is sustained return of spontaneous circulation and key secondary outcomes include survival and survival with a favourable neurological outcome at 30 days. A total of 1,470 patients will be included. Results: The trial started in March 2022 and the last patient is anticipated to be included in the spring of 2024. The primary results will be reported after 90-day follow-up and are anticipated in mid-2024. Conclusion: The current article describes the design of the Danish IVIO trial. The findings of this trial will help inform future guidelines for selecting the optimal vascular access route during out-of-hospital cardiac arrest. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Authors.)
Databáze:	MEDLINE
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