Meta AnalysisID 1273

心脏骤停期间使用钙剂的系统评价

CRD42022349641

Among adults and children who are in cardiac arrest in any setting (P), does calcium administration (I), compared with no calcium administration (C), change outcome (O)?

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Meta Analysis Id: 1273
Evidence Id: 9831
Core Evidence Id: 9831
Source Meta Analysis Id: 1236
Herb2 Meta Analysis Id: HBMA001236
Crd Id: CRD42022349641
Title: Calcium During Cardiac Arrest: A Systematic Review
Review Question: Among adults and children who are in cardiac arrest in any setting (P), does calcium administration (I), compared with no calcium administration (C), change outcome (O)?
Study Type Included: Randomized controlled trials (RCTs) and non-randomized studies (non-randomized controlled trials, interrupted time series, controlled before-and-after studies, cohort studies) with a control group are eligible for inclusion. Ecological studies, case series, case reports, reviews, abstracts, editorials, comments, letters to the editor, and unpublished studies will be excluded. All years and all languages are included if there is an English abstract.
Condition Being Studied: Calcium administration during cardiac arrest has been shown to have variable results on the outcome of cardiac arrest patients. Small randomized controlled trials did not demonstrate beneficial effects of calcium on survival of in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA). Observational studies have been limited by high risk of bias. The American Heart Association and European Resuscitation Council currently recommend against routine administration of calcium for treatment of cardiac arrest. The most recent International Liaison Committee on Resuscitation (ILCOR) review on this topic was in 2010, at which time the treatment recommendation was: “Routine administration of calcium for treatment of in-hospital and out-of-hospital cardiac arrest is not recommended.” Yet, calcium administration remains common. The publication of a recent randomized controlled trial Calcium for Out-of-Hospital Cardiac Arrest adds new randomized data to the existing evidence on this topic, prompting an updated systematic review.
Participant: Adults and children in any setting (in-hospital or out-of-hospital) with cardiac arrest
Animal
Human Disease Modelled
Intervention: Administration of calcium (intravenous or intraosseous) during cardiac arrest
Comparator Control: No administration of calcium during cardiac arrest
Main Outcome: Any clinical outcome, including return of spontaneous circulation, short-term survival and neurological outcomes (e.g., hospital discharge, 28-days, 30-days, and 1-month) and long-term survival and neurological outcomes (e.g., 3-months, 6-months, 1-year) Measures of effect In the case of heterogeneity in studies included in meta-analyses, meta-regression will be conducted to identify potential determinants of heterogeneity. The following variables are specified a priori for inclusion in the univariate model: sample size (continuous), continent of conduct (North America, Europe, Asia, and other), year of patient enrollment (continuous), participant age (continuous), and initial cardiac rhythm (proportion of shockable rhythms). If there is a sufficient ratio of studies to covariates, each covariate will be entered in a multivariate meta-regression model using a backward elimination approach at a p-value > 0.05. If this is not the case, only bivariable assessments will be made. Meta-regression will only be performed if the number of studies is ≥ 10. Publication bias will be evaluated using funnel plots, the Egger test, the Begg test, and the Harbord test as appropriate, depending on the degree of heterogeneity observed. However, these statistical tests will only be conducted if the number of studies is ≥ 10 for any given analysis. The Number needed to treat (NNT) will be calculated based on the pooled odds/risk ratios and various estimates of baseline risk if applicable.
Outcome Measure
Additional Outcome
Study Method: Intervention, Meta-analysis, Systematic review
Keyword: Calcium; Cardiopulmonary Resuscitation; Heart Arrest; Humans
Contact: Cindy H. Hsu [email protected]
Organisational Affiliation: International Liaison Committee on Resuscitation www.ilcor.org
Funding Source: There was no funding for this review.
Other Selection Criteria
Final Publication
Same Topic Review
Published Protocol
Review Type
Language: English
Country: United States of America
Review Stage: Review Ongoing
First Submission Date: 2022-07-27
Registration Date: 2022-08-07
Anticipated Start Date: 2022-08-01
Anticipated Completion Date: 2022-10-31
Title Cn: 心脏骤停期间使用钙剂的系统评价
Title En: Calcium During Cardiac Arrest: A Systematic Review
Bilingual Status: complete