Evidence map›Paper›PMID 38286499›Full record

ArticleClinical and experimental emergency medicine2024

A multicenter, randomized, doubleblind, placebo-controlled trial of amantadine to stimulate awakening in comatose patients resuscitated from cardiac arrest.

Patrick J Coppler, David J Gagnon, Katharyn L Flickinger, Jonathan Elmer, Clifton W Callaway, Francis X Guyette, Ankur Doshi, Alexis Steinberg, Cameron Dezfulian, Ari L Moskowitz and 4 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and experimental emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
6.9field-weighted citation impact, top 3% 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, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Guideline
  2. Article
  3. Article
  4. 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

14 authors at 6 institutions in 1 country.

Patrick J CopplerDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
David J GagnonDepartment of Critical Care Services, Maine Medical Center, Portland, ME, USA.
Katharyn L FlickingerDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Jonathan ElmerDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Clifton W CallawayDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Francis X GuyetteDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Ankur DoshiDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Alexis SteinbergDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Cameron DezfulianDepartment of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Ari L MoskowitzDepartment of Medicine, Albert Einstein College of Medicine, New York, NY, USA.
Michael DonninoDepartment of Medicine, Beth Israel Deaconess, Boston, MA, USA.
Teresa L MayDepartment of Critical Care Services, Maine Medical Center, Portland, ME, USA.
David B SederDepartment of Critical Care Services, Maine Medical Center, Portland, ME, USA.
Jon C RittenbergerDepartment of Emergency Medicine, Geisinger Commonwealth School of Medicine, Scranton, PA, USA.
University of Pittsburgh · USMaine Medical Center · USAlbert Einstein College of Medicine · USBaylor College of Medicine · USBeth Israel Deaconess Hospital · USGeisinger Commonwealth School of Medicine · US

Funding

Telemedicine to Reduce Disparities in the Identification and Treatment of Neonatal EncephalopathyP20GM139745 · NIGMS · MAINEHEALTH · PI David B. Seder · 2021 to 2026
$19.2M
NIGMS NIH HHS P20 GM139745
6 · The paper itself

Abstract

objectiveWe hypothesized that the administration of amantadine would increase awakening of comatose patients resuscitated from cardiac arrest.

methodsWe performed a prospective, randomized, controlled pilot trial, randomizing subjects to amantadine 100 mg twice daily or placebo for up to 7 days. The study drug was administered between 72 and 120 hours after resuscitation and patients with absent N20 cortical responses, early cerebral edema, or ongoing malignant electroencephalography patterns were excluded. Our primary outcome was awakening, defined as following two-step commands, within 28 days of cardiac arrest. Secondary outcomes included length of stay, awakening, time to awakening, and neurologic outcome measured by Cerebral Performance Category at hospital discharge. We compared the proportion of subjects awakening and hospital survival using Fisher exact tests and time to awakening and hospital length of stay using Wilcoxon rank sum tests.

resultsAfter 2 years, we stopped the study due to slow enrollment and lapse of funding. We enrolled 14 subjects (12% of goal enrollment), seven in the amantadine group and seven in the placebo group. The proportion of patients who awakened within 28 days after cardiac arrest did not differ between amantadine (n=2, 28.6%) and placebo groups (n=3, 42.9%; P>0.99). There were no differences in secondary outcomes. Study medication was stopped in three subjects (21.4%). Adverse events included a recurrence of seizures (n=2; 14.3%), both of which occurred in the placebo group.

conclusionWe could not determine the effect of amantadine on awakening in comatose survivors of cardiac arrest due to small sample size.

Indexed as

AmantadineBrain hypoxiaComaHeart arrest

Identifiers

PMID38286499
PMCPMC11237252
OpenAlexW4391329001

What OpenQuestion holds

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Registered trials

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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.