Intravenous vs. intraosseous vascular access during out-of-hospital cardiac arrest – protocol for a randomised clinical trial

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  • Carsten Meilandt
  • Mikael Fink Vallentin
  • Kristian Blumensaadt Winther
  • Allan Bach
  • Thomas H. Dissing
  • Steffen Christensen
  • Christian Juhl Terkelsen
  • Thomas Lass Klitgaard
  • Søren Mikkelsen
  • Folke, Fredrik
  • Asger Granfeldt
  • Lars W. Andersen

Objective: During cardiac arrest, current guidelines recommend attempting intravenous access first and to consider intraosseous access if intravenous access is unsuccessful or impossible. However, these recommendations are only based on very low-certainty evidence. Therefore, the “Intravenous vs Intraosseous Vascular Access During Out-of-Hospital Cardiac Arrest“ (IVIO) trial aims to determine whether there is a difference in patient outcomes depending on the type of vascular access attempted during out-of-hospital cardiac arrest. This current article describes the clinical IVIO trial. Methods: The IVIO trial is an investigator-initiated, randomised trial of intravenous vs. intraosseous vascular access during adult non-traumatic out-of-hospital cardiac arrest in Denmark. The intervention will consist of minimum two attempts (if unsuccessful on the first attempt) to successfully establish intravenous or intraosseous vascular access during cardiac arrest. The intraosseous group will be further randomised to the humeral or tibial site. The primary outcome is sustained return of spontaneous circulation and key secondary outcomes include survival and survival with a favourable neurological outcome at 30 days. A total of 1,470 patients will be included. Results: The trial started in March 2022 and the last patient is anticipated to be included in the spring of 2024. The primary results will be reported after 90-day follow-up and are anticipated in mid-2024. Conclusion: The current article describes the design of the Danish IVIO trial. The findings of this trial will help inform future guidelines for selecting the optimal vascular access route during out-of-hospital cardiac arrest.

TidsskriftResuscitation Plus
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Funding for the trial is provided by the Novo Nordisk Foundation, Aarhus University, TrygFonden, the Independent Research Fund Denmark, and Snedkermester Sophus Jacobsen og hustru Astrid Jacobsens Fond through The Danish Heart Foundation. The funding agencies will have no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Publisher Copyright:
© 2023 The Authors

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