Key result
Nimodipine shows no benefit over placebo for 1-year survival after out-of-hospital VF.
Why the study?
The potential benefit of nimodipine after resuscitation from out-of-hospital ventricular fibrillation was uncertain.
Does nimodipine improve 1-year survival in patients resuscitated after out-of-hospital ventricular fibrillation?
RCT (n=155)
Does nimodipine improve 1-year survival in patients resuscitated after out-of-hospital ventricular fibrillation?
Absolute Event Rate: 40% vs 36%
Intravenous nimodipine did not significantly improve 1-year survival in patients resuscitated from out-of-hospital ventricular fibrillation, though it reduced recurrent ventricular fibrillation during treatment.
Nimodipine should not be used to improve survival after out-of-hospital VF; this RCT confirms no 1-year benefit versus placebo.
One hundred fifty-five consecutive patients resuscitated after out-of-hospital ventricular fibrillation by a physician-manned advanced life support unit were randomly assigned to receive nimodipine or placebo at a dosage of 10 μg/kg as an intravenous injection immediately after restoration of spontaneous circulation, followed by an infusion of 0.5 μg/kg per minute for 24 hours. No significant difference was found in the 1-year survival rate of nimodipine-treated (30 [40%] of 75 patients) and placebo-treated patients (29 [36%] of 80 patients). Recurrent ventricular fibrillation during the treatment occurred in one patient in the nimodipine group compared with 12 patients in the placebo group. In a post hoc analysis of patients with very long delays in advanced life support (more than 10 minutes), the 1-year survival rate was higher with nimodipine (eight [47%] of 17 patients) than with placebo (two [8%] of 26 patients). Nimodipine may be of benefit in patients with delayed resuscitation. (JAMA. 1990;264:3171-3177)
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Risto O. Roine (1990) conducted an RCT in Out-of-hospital ventricular fibrillation (n=155). Nimodipine vs. Placebo was evaluated on 1-year survival rate. Nimodipine did not significantly improve the 1-year survival rate compared to placebo (40% vs 36%) in patients resuscitated after out-of-hospital ventricular fibrillation.
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