Evidence map›Paper›PMID 37068900›Full record

SynthesisBMJ open2023

Therapeutic effects of vasopressin on cardiac arrest: a systematic review and meta-analysis.

Wenqing Yan, Weihua Dong, Xin Song, Wenqiang Zhou, Zhi Chen

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open, 2023. 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
3.1field-weighted citation impact, top 9% 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

1 citing paper in PubMed, 9 citations in OpenAlex.

  1. Article
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

5 authors at 2 institutions in 1 country.

Wenqing YanDepartment of Emergency, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, People's Republic of China.ORCID 0000-0003-3980-0868
Weihua DongDepartment of Emergency, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, People's Republic of China zhichen@tongji.edu.cn Dong@email.ncu.edu.cn.
Xin SongDepartment of Emergency, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, People's Republic of China.
Wenqiang ZhouDepartment of Emergency, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, People's Republic of China.
Zhi ChenDepartment of Emergency, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, People's Republic of China zhichen@tongji.edu.cn Dong@email.ncu.edu.cn.ORCID 0000-0002-9467-9151
Nanchang University · CNJiangxi Provincial People's Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo demonstrate the therapeutic effect of vasopressin as an alternative treatment for cardiac arrest.

designSystematic review and meta-analysis.

methodsPubMed, EMBASE, the Cochrane Library and Web of Science were searched for randomised controlled trials. The intervention included administration of vasopressin alone or vasopressin combined with epinephrine or vasopressin, steroids and epinephrine (VSE) versus epinephrine combined with placebo as control group. The primary outcome was the return of spontaneous circulation (ROSC). The secondary outcomes included mid-term survival and mid-term good neurological outcome. We conducted subgroup analyses of the primary outcome based on different settings, different study drug strategies and different types of initial rhythm.

resultsTwelve studies (n=6718) were included, of which eight trials (n=5638) reported the data on patients with out-of-hospital cardiac arrest and four trials (n=1080) on patients with in-hospital cardiac arrest (IHCA). There were no significant differences between intravenous vasopressin and placebo in the outcomes of ROSC (relative risk (RR): 1.11; 95% CI: 0.99 to 1.26), mid-term survival (RR: 1.23; 95% CI: 0.90 to 1.66) and mid-term good neurological outcome (RR: 1.20; 95% CI: 0.77 to 1.87). However, in the subgroup analysis, intravenous vasopressin as part of VSE can significantly improve the rate of ROSC (RR: 1.32; 95% CI: 1.18 to 1.47) but not the rate of mid-term survival (RR: 2.15; 95% CI: 0.75 to 6.16) and mid-term good neurological outcome (RR: 1.80; 95% CI: 0.81 to 4.01) for patients with IHCA.

conclusionsOur study failed to demonstrate increased benefit from vasopressin with or without epinephrine compared with the standard of care. However, vasopressin as a part of VSE is associated with the improvement of ROSC in patients with IHCA, and the benefit on mid-term survival or mid-term good neurological outcome is uncertain. Larger trials should be conducted in the future to address the effect of vasopressin only, vasopressin plus epinephrine or VSE on cardiac arrest. PROSPERO REGISTRATION NUMBER: CRD42021293347.

Indexed as

Cardiopulmonary ResuscitationOut-of-Hospital Cardiac ArrestEpinephrineHumansVasoconstrictor AgentsVasopressinsEpinephrineVasoconstrictor AgentsVasopressinsACCIDENT & EMERGENCY MEDICINEAdult intensive & critical careCARDIOLOGY

Identifiers

PMID37068900
PMCPMC10111914
OpenAlexW4366084650

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.