Evidence map›Paper›PMID 30407950›Full record

Observational studyCritical care medicine2019

Trends Over Time in Drug Administration During Adult In-Hospital Cardiac Arrest.

Ari Moskowitz, Catherine E Ross, Lars W Andersen, Anne V Grossestreuer, Katherine M Berg, Michael W Donnino, American Heart Association’s Get With The Guidelines – Resuscitation Investigators

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Review
  7. Article
  8. In-Hospital Cardiac Arrest.Emergency medicine clinics of North America · 2023
    Review
  9. Observational
  10. Review
  11. Out-of-hospital cardiac arrest.Intensive care medicine · 2023
    Article
  12. Improving vasopressor use in cardiac arrest.Critical care (London, England) · 2023
    Review
  13. Review
  14. Review
  15. Article
  16. Article
  17. Article
  18. Observational
  19. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Ari MoskowitzDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Catherine E RossDivision of Medicine Critical Care, Department of Medicine, Boston Children's Hospital, Boston, MA.
Lars W AndersenResearch Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
Anne V GrossestreuerDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Katherine M BergDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Michael W DonninoDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
American Heart Association’s Get With The Guidelines – Resuscitation Investigators
Beth Israel Deaconess Medical Center · USAarhus University Hospital · DKBoston Children's Hospital · US

Funding

Harvard Clinical and Translational Science CenterUL1TR001102 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$106.2M
Harvard Clinical and Translational Science CenterKL2TR001100 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$8.5M
Training Program in Cardiovascular ResearchT32HL007374 · NHLBI · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI MITTLEMAN, MURRAY A · 1985 to 2019
$7.9M
Thiamine As A Metabolic Resuscitator In Cardiac ArrestR01HL136705 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI DONNINO, MICHAEL WILLIAM · 2017 to 2021
$2.2M
Thaimine as an adjunct metabolic resuscitator in cardiac arrestK24HL127101 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI DONNINO, MICHAEL WILLIAM · 2015 to 2024
$1.2M
Thiamine v placebo to improve oxygen consumption after in-hospital cardiac arrestK23HL128814 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI BERG, KATHERINE M · 2016 to 2021
$1.0M
Thiamine as a Renal Protective Agent in Septic ShockK23GM128005 · NIGMS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MOSKOWITZ, ARI · 2018 to 2021
$761k
NCATS NIH HHS KL2 TR001100NCATS NIH HHS UL1 TR001102NHLBI NIH HHS K23 HL128814NHLBI NIH HHS K24 HL127101NHLBI NIH HHS R01 HL136705NHLBI NIH HHS T32 HL007374NIGMS NIH HHS K23 GM128005
6 · The paper itself

Abstract

objectivesClinical providers have access to a number of pharmacologic agents during in-hospital cardiac arrest. Few studies have explored medication administration patterns during in-hospital cardiac arrest. Herein, we examine trends in use of pharmacologic interventions during in-hospital cardiac arrest both over time and with respect to the American Heart Association Advanced Cardiac Life Support guideline updates.

designObservational cohort study.

settingHospitals contributing data to the American Heart Association Get With The Guidelines-Resuscitation database between 2001 and 2016. PATIENTS: Adult in-hospital cardiac arrest patients.

interventionsThe percentage of patients receiving epinephrine, vasopressin, amiodarone, lidocaine, atropine, bicarbonate, calcium, magnesium, and dextrose each year were calculated in patients with shockable and nonshockable initial rhythms. Hierarchical multivariable logistic regression was used to determine the annual adjusted odds of medication administration. An interrupted time series analysis was performed to assess change in atropine use after the 2010 American Heart Association guideline update. MEASUREMENTS AND MAIN

resultsA total of 268,031 index in-hospital cardiac arrests were included. As compared to 2001, the adjusted odds ratio of receiving each medication in 2016 were epinephrine (adjusted odds ratio, 1.5; 95% CI, 1.3-1.8), vasopressin (adjusted odds ratio, 1.5; 95% CI, 1.1-2.1), amiodarone (adjusted odds ratio, 3.4; 95% CI, 2.9-4.0), lidocaine (adjusted odds ratio, 0.2; 95% CI, 0.2-0.2), atropine (adjusted odds ratio, 0.07; 95% CI, 0.06-0.08), bicarbonate (adjusted odds ratio, 2.0; 95% CI, 1.8-2.3), calcium (adjusted odds ratio, 2.0; 95% CI, 1.7-2.3), magnesium (adjusted odds ratio, 2.2; 95% CI, 1.9-2.7; p < 0.0001), and dextrose (adjusted odds ratio, 2.8; 95% CI, 2.3-3.4). Following the 2010 American Heart Association guideline update, there was a downward step change in the intercept and slope change in atropine use (p < 0.0001).

conclusionsPrescribing patterns during in-hospital cardiac arrest have changed significantly over time. Changes to American Heart Association Advanced Cardiac Life Support guidelines have had a rapid and substantial effect on the use of a number of commonly used in-hospital cardiac arrest medications.

Indexed as

AgedAmiodaroneAnti-Arrhythmia AgentsAtropineBicarbonatesCalciumEpinephrineFemaleGlucoseGuideline AdherenceHeart ArrestHospitalizationHumansLidocaineLogistic ModelsMagnesiumAmiodaroneAnti-Arrhythmia AgentsAtropineBicarbonatesCalciumEpinephrineGlucoseLidocaineMagnesiumVasoconstrictor AgentsVasopressins

Identifiers

PMID30407950
PMCPMC6336500
OpenAlexW2899587250

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.