OBJECTIVE: To evaluate the feasibility, safety, and efficacy of interventions aimed at improving neurologic outcome after cardiac arrest. METHODS: The authors conducted a double-blind, placebo-controlled, randomized clinical trial with factorial design to see if magnesium, diazepam, or both, when given immediately following resuscitation from out-of-hospital cardiac arrest, would increase the proportion of patients awakening, defined as following commands or having comprehensible speech. If the patient regained a systolic blood pressure of at least 90 mm Hg and had not awakened, paramedics injected IV two syringes stored in a sealed kit. The first always contained either 2 g magnesium sulfate (M) or placebo (P); the second contained either 10 mg diazepam (D) or P. Awakening at any time by 3 months was determined by record review, and independence at 3 months was determined by telephone calls. Over 30 months, 300 patients were randomized in balanced blocks of 4, 75 each to MD, MP, PD, or PP. The study was conducted under waiver of consent. RESULTS: Despite the design, the four treatment groups differed on baseline variables collected before randomization. Percent awake by 3 months for each group were: MD, 29.3%; MP, 46.7%; PD, 30.7%; PP, 37.3%. Percent independent at 3 months were: MD, 17.3%; MP, 34.7%; PD, 17.3%; PP, 25.3%. Significant interactions were lacking. After adjusting for baseline imbalances, none of these differences was significant, and no adverse effects were identified. CONCLUSIONS: Neither magnesium nor diazepam significantly improved neurologic outcome from cardiac arrest.
RCT Entities:
OBJECTIVE: To evaluate the feasibility, safety, and efficacy of interventions aimed at improving neurologic outcome after cardiac arrest. METHODS: The authors conducted a double-blind, placebo-controlled, randomized clinical trial with factorial design to see if magnesium, diazepam, or both, when given immediately following resuscitation from out-of-hospital cardiac arrest, would increase the proportion of patients awakening, defined as following commands or having comprehensible speech. If the patient regained a systolic blood pressure of at least 90 mm Hg and had not awakened, paramedics injected IV two syringes stored in a sealed kit. The first always contained either 2 g magnesium sulfate (M) or placebo (P); the second contained either 10 mg diazepam (D) or P. Awakening at any time by 3 months was determined by record review, and independence at 3 months was determined by telephone calls. Over 30 months, 300 patients were randomized in balanced blocks of 4, 75 each to MD, MP, PD, or PP. The study was conducted under waiver of consent. RESULTS: Despite the design, the four treatment groups differed on baseline variables collected before randomization. Percent awake by 3 months for each group were: MD, 29.3%; MP, 46.7%; PD, 30.7%; PP, 37.3%. Percent independent at 3 months were: MD, 17.3%; MP, 34.7%; PD, 17.3%; PP, 25.3%. Significant interactions were lacking. After adjusting for baseline imbalances, none of these differences was significant, and no adverse effects were identified. CONCLUSIONS: Neither magnesium nor diazepam significantly improved neurologic outcome from cardiac arrest.
Authors: Jon C Rittenberger; Alexandra Popescu; Richard P Brenner; Francis X Guyette; Clifton W Callaway Journal: Neurocrit Care Date: 2012-02 Impact factor: 3.210
Authors: Clifton W Callaway; Michael W Donnino; Ericka L Fink; Romergryko G Geocadin; Eyal Golan; Karl B Kern; Marion Leary; William J Meurer; Mary Ann Peberdy; Trevonne M Thompson; Janice L Zimmerman Journal: Circulation Date: 2015-11-03 Impact factor: 29.690
Authors: Jeffrey L Saver; Sidney Starkman; Marc Eckstein; Samuel Stratton; Frank Pratt; Scott Hamilton; Robin Conwit; David S Liebeskind; Gene Sung; Nerses Sanossian Journal: Int J Stroke Date: 2014-02 Impact factor: 5.266
Authors: Jeffrey L Saver; Sidney Starkman; Marc Eckstein; Samuel Stratton; Frank Pratt; Scott Hamilton; Robin Conwit; David S Liebeskind; Gene Sung; Nerses Sanossian Journal: Int J Stroke Date: 2014-01-13 Impact factor: 5.266
Authors: J P Nolan; C D Deakin; J Soar; B W Böttiger; G Smith; M Baubin; B Dirks; V Wenzel Journal: Notf Rett Med Date: 2006-02-01 Impact factor: 0.826
Authors: Stephen Trzeciak; Alan E Jones; J Hope Kilgannon; Brian M Fuller; Brian W Roberts; Joseph E Parrillo; John T Farrar Journal: Resuscitation Date: 2009-04-21 Impact factor: 5.262