The following is a summary of “Efficacy and safety of corticosteroid therapy in patients with cardiac arrest: A meta-analysis of randomized controlled trials,” published in the January 2024 issue of Emergency Medicine by Zhou, et al.

The clinical efficacy of corticosteroid therapy during cardiac arrest (CA) remains uncertain. Recent trials have suggested potential benefits, but overall outcomes could be clearer. For a study, researchers sought to evaluate whether corticosteroid administration improves outcomes in post-CA patients.

They systematically searched PubMed, Embase, Cochrane Library, Web of Science, and CNKI databases for randomized controlled trials comparing corticosteroid therapy to placebo during CA.

About 11 relevant studies involving 2,273 patients were included. Meta-analysis showed that corticosteroid treatment during CA significantly increased the rate of sustained return of spontaneous circulation (ROSC) (OR: 2.05, 95% CI: 1.24 to 3.37, P < 0.01). However, corticosteroid treatment did not significantly improve favorable neurological outcomes (OR: 1.13, 95% CI: 0.81 to 1.58, P = 0.49) or overall survival rate at hospital discharge (OR: 1.29, 95% CI: 0.74 to 2.26, P = 0.38). Subgroup analysis revealed a significantly increased survival rate and ROSC with corticosteroid doses above 100 mg methylprednisolone. There were no significant differences in adverse events.

High-dose corticosteroid therapy (above 100 mg methylprednisolone) was associated with an improved overall survival rate at hospital discharge and ROSC outcomes following CA. However, its impact on favorable neurological outcomes remained uncertain.

Reference: sciencedirect.com/science/article/pii/S0735675723005727