ArticleJournal of the American Heart Association2024
Intraosseous and Intravenous Epinephrine Administration Routes in Out-of-Hospital Cardiac Arrest: Survival and Neurologic Outcomes.
Article in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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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.
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Who cites it
6 citing papers in PubMed.
- Comparison of Prehospital Vascular Access Methods and Their Association with Survival in Out-of-Hospital Cardiac Arrest.International journal of general medicine · 2026Article
- Does the Injection Site Matter During CPR? A Systematic Review and Meta-Analysis of Drug Pharmacokinetics and Pharmacodynamics.Journal of clinical medicine · 2025Review
- Intraosseous route is associated with prolonged epinephrine-to-ROSC interval in out-of-hospital cardiac arrest.Irish journal of medical science · 2025Article
- Intraosseous vs. intravenous access in out-of-hospital cardiac arrest: a systematic review and meta-analysis of clinical outcomes.International journal of emergency medicine · 2025Review
- Intraosseous versus intravenous fluid resuscitation in gastrointestinal tumor-related acute hemorrhage: impact on 30-day mortality and lactate clearance.American journal of cancer research · 2025Article
- Safety and Efficacy of Intra-Osseous versus Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis.Therapeutics and clinical risk management · 2025Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe rate of survival after out-of-hospital cardiac arrest varies depending on the timeliness and effectiveness of prehospital interventions. This study was conducted to compare out-of-hospital cardiac arrest outcomes between intravenous and intraosseous routes and between upper and lower extremity routes for drug administration. METHODS AND
resultsWe retrospectively analyzed data (collected using the Utstein template) from 1220 patients who had experienced out-of-hospital cardiac arrest in Taiwan's Taoyuan City between January 2021 and August 2023. The patients were stratified into intravenous and intraosseous groups by treatment approach and upper and lower extremity access groups by access site. The study outcomes were survival to discharge, favorable neurologic outcomes (Cerebral Performance Category score 1 or 2), and survival for >2 hours. The study groups were statistically compared before and after propensity score matching. Significant pre-propensity score matching differences were observed between intravenous and intraosseous groups, and the aforementioned study outcomes were better in the intravenous group than in the intraosseous group. However, the between-group differences became nonsignificant after propensity score matching. Furthermore, lower extremity access and delayed epinephrine administration were associated with worse outcomes. Survival rates fell below 12.6% when time to treatment exceeded 15 minutes, particularly in the cases of intraosseous access and lower extremity access.
conclusionsThis study highlights the benefits of early intervention and upper extremity access for drug administration in patients with out-of-hospital cardiac arrest. Intraosseous access may serve as a viable alternative to intravenous access. Timely administration of essential drugs during resuscitation can improve clinical outcomes and thus has implications for emergency medical service training.
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