Evidence map›Paper›PMID 34273470›Full record

ArticleResuscitation2021

Impact of intraosseous versus intravenous resuscitation during in-hospital cardiac arrest: A retrospective study.

Kevin T Schwalbach, Sylvia S Yong, R Chad Wade, Joseph Barney

Open access · greenAbstract read
In one paragraph

Article in Resuscitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.4field-weighted citation impact, top 11% 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

4 citing papers in PubMed, 13 citations in OpenAlex.

  1. Review
  2. Review
  3. Intraosseous access in resuscitation.Critical care (London, England) · 2025
    Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Kevin T SchwalbachUniversity of Alabama at Birmingham, Department of Medicine, 1720 2nd Ave South, BDB 321, Birmingham, AL 35294-0012, United States.
Sylvia S YongUniversity of Alabama at Birmingham, Department of Medicine, 1720 2nd Ave South, BDB 321, Birmingham, AL 35294-0012, United States.
R Chad WadeUniversity of Alabama at Birmingham Division of Pulmonary, Allergy and Critical Care Medicine, 1900 University Blvd., Tinsley Harrison Tower, Suite 422, Birmingham, AL 35294, United States.
Joseph BarneyUniversity of Alabama at Birmingham Division of Pulmonary, Allergy and Critical Care Medicine, 1900 University Blvd., Tinsley Harrison Tower, Suite 422, Birmingham, AL 35294, United States. Electronic address: jbarney@uabmc.edu.
University of Alabama at Birmingham · US

Funding

National Dissemination of I-Corps@NCATS: Accelerating Translation through CommercializationUL1TR003096 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GUTIERREZ, ORLANDO M, KIMBERLY, ROBERT P. · 2019 to 2023
$43.6M
NCATS NIH HHS UL1 TR003096
6 · The paper itself

Abstract

aimTo compare outcomes between Intraosseous (IO) and peripheral intravenous (PIV) injection during in-hospital cardiac arrest (IHCA) and examine its utility in individuals with obesity.

methodsWe performed a retrospective cohort analysis of adult, atraumatic IHCA at a single tertiary care center. Subjects were classified as either IO or PIV resuscitation. The primary outcome of interest was survival to hospital discharge. The secondary outcomes of interest were survival with favourable neurologic status, rates-of-ROSC (ROR) and time-to-ROSC (TTR). Subgroup analysis among patients with BMI ≥ 30 kg/m

resultsComplete data were available for 1852 subjects, 1039 of whom met eligibility criteria. A total of 832 were resuscitated via PIV route and 207 via IO route. Use of IO compared to PIV was associated with lower overall survival to hospital discharge (20.8% vs 28.4% p = 0.03), lower rates of survival with favourable neurologic status (18.4% vs 25.2% p = 0.04), lower ROR (72.2% vs 80.7%) and longer TTR (12:38 min vs 9:01 min). After multivariate adjustment there was no significant differences between IO and PIV in rates of survival to discharge (OR 0.71, 95% CI 0.47-1.06, p = 0.09) or rates of survival with favourable neurologic status (OR 0.74, 95% CI 0.49-1.13, p = 0.16). The ROR and TTR remained significantly worse in the IO group. Subgroup analysis of patients with BMI ≥ 30 kg/m

conclusionIntraosseous medication delivery is associated with inferior rates-of-ROSC and longer times-to-ROSC compared to PIV, but no differences in overall survival to hospital discharge or survival with favourable neurologic status during IHCA.

Indexed as

Cardiopulmonary ResuscitationOut-of-Hospital Cardiac ArrestAdultEpinephrineHospitalsHumansInfusions, IntraosseousRetrospective StudiesEpinephrineIn-Hospital Cardiac Arrest (IHCA)IntraosseousObesityResuscitation

Identifiers

PMID34273470
PMCPMC8795983
OpenAlexW3180224268

What OpenQuestion holds

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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.