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. 2022 Apr 11;22(2):67-74.
doi: 10.4103/2452-2473.342805. eCollection 2022 Apr-Jun.

Association between calcium administration and outcomes during adult cardiopulmonary resuscitation at the emergency department

Wachira Wongtanasarasin  1 , Nat Ungrungseesopon  1 , Nutthida Namsongwong  1 , Pongsatorn Chotipongkul  1 , Onwara Visavakul  1 , Napatsakorn Banping  1 , Worapot Kampeera  2 , Phichayut Phinyo  3   4
Affiliations

Association between calcium administration and outcomes during adult cardiopulmonary resuscitation at the emergency department

Wachira Wongtanasarasin et al. Turk J Emerg Med. .

Abstract

Objectives: Calcium administration during cardiac arrest is limited in some circumstances, mainly due to lack of consistent evidence. This study aims to investigate whether calcium therapy administered during cardiac arrest at the Emergency Department is associated with good outcomes, including the probability of return of spontaneous circulation (ROSC), survival to hospital admission, survival to hospital discharge, and favorable neurological outcome at discharge.

Methods: We retrospectively reviewed 599 consecutive adult cardiac arrest events between 2016 and 2018. The primary outcome was the ROSC rate. Secondary outcomes included survival to hospital admission, survival to hospital discharge, and favorable neurologic outcome at hospital discharge. Multivariable logistic regression with inverse probability of treatment weighting was analyzed to examine the association between calcium administration and outcomes.

Results: Of 599 events, calcium was administered in 72 (12%) cases. The use of calcium during cardiopulmonary resuscitation (CPR) after adjusting for confounding factors was not associated with any better outcomes, including ROSC (adjusted odds ratio (aOR) 0.53, 95% confidence interval [CI] 0.24-1.17), survival to hospital admission (aOR 1.07, 95% CI 0.47-2.41), survival to hospital discharge (aOR 1.93, 95% CI 0.43-8.56), and favorable neurological outcome (aOR 6.60, 95% CI 0.72-60.74). Besides, calcium use in traumatic cardiac arrest patients was associated with unfavorable outcomes, including ROSC (aOR 0.02, 95% CI 0.00-0.09) and survival to hospital admission (aOR 0.16, 95% CI 0.03-0.84).

Conclusion: The use of calcium during an adult cardiac arrest was not associated with better outcomes. Although associations drawn from this study did not indicate the causality, given calcium during CPR was linked to poorer outcomes in traumatic cardiac arrest patients, including ROSC and survival to hospital admission.

Keywords: Calcium; cardiac arrest; emergency department; outcomes; survival.

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Conflict of interest statement

None Declared.

Figures

Figure 1
Figure 1
Study flowchart
Figure 2
Figure 2
Balance in prognostic factors at baseline based on absolute standardized difference in the unweighted and weighted samples. CPR: Cardiopulmonary resuscitation, ED: Emergency department
Figure 3
Figure 3
Weighted multivariable logistic regression analysis separated by outcomes and stratified by mechanism of cardiac arrest. CI: Confidence interval, N/A: not applicable, OR: Odds ratio, ROSC: Return of spontaneous circulation
See this image and copyright information in PMC

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