Evidence map›Paper›PMID 30771452›Full record

Observational studyResuscitation2019

Guideline removal of atropine and survival after adult in-hospital cardiac arrest with a non-shockable rhythm.

Mathias J Holmberg, Ari Moskowitz, Sebastian Wiberg, Anne V Grossestreuer, Tuyen Yankama, Lise Witten, Sarah M Perman, Michael W Donnino, Lars W Andersen, 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 Resuscitation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Compound Tongyang Fumai decoction improves quality of life in sick sinus syndrome: a randomized controlled study.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2024
    Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mathias J HolmbergResearch Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address: mholmber@bidmc.harvard.edu.
Ari MoskowitzCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Sebastian WibergCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
Anne V GrossestreuerCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Tuyen YankamaCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Lise WittenCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Emergency Medicine, Odense University Hospital, Odense, Denmark.
Sarah M PermanDepartment of Emergency Medicine, University of Colorado, Denver, Colorado, USA.
Michael W DonninoCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Lars W AndersenResearch Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Intensive Care Medicine, Randers Regional Hospital, Randers, Denmark.
American Heart Association’s Get With The Guidelines®-Resuscitation Investigators

Funding

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 as a Renal Protective Agent in Septic ShockK23GM128005 · NIGMS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MOSKOWITZ, ARI · 2018 to 2021
$761k
NHLBI NIH HHS K24 HL127101NHLBI NIH HHS R01 HL136705NIGMS NIH HHS K23 GM128005
6 · The paper itself

Abstract

aimTo determine whether the removal of atropine from the 2010 ACLS guidelines for non-shockable cardiac arrests was associated with a change in survival.

methodsUsing the Get With The Guidelines

resultsWe included 20,499 non-shockable and 3968 shockable cardiac arrests. Patient characteristics were similar between the pre-guidelines and post-guidelines period. Atropine was used for 8653 (87%) non-shockable and 680 (35%) shockable cardiac arrests in the pre-guidelines period and 3643 (35%) non-shockable and 320 (16%) shockable cardiac arrests in the post-guidelines period. The change over time in survival from the pre-guidelines to the post-guidelines period was not significantly different for the non-shockable compared to the shockable cohort (risk difference: 2.0% [95%CI: -0.8, 4.8] per year, p = 0.17). The immediate change in survival after introducing the guidelines was also not different between the cohorts (risk difference: 3.5% [95%CI: -2.6, 9.7], p = 0.26). Results were similar for the secondary outcomes and in multiple sensitivity analyses.

conclusionsThe removal of atropine from the 2010 guidelines was not associated with a significant change in survival.

Indexed as

Practice Guidelines as TopicAgedAnti-Arrhythmia AgentsAtropineElectric CountershockFemaleHeart ArrestHumansInterrupted Time Series AnalysisMaleMiddle AgedPropensity ScoreProspective StudiesRegistriesSurvival RateUnited StatesAnti-Arrhythmia AgentsAtropineAdvanced cardiac life supportAmerican heart associationAtropineGuidelineHeart arrestInterrupted time series analysis

Identifiers

PMID30771452
PMCPMC6467532

What OpenQuestion holds

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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.