Study Finds Sodium Nitrite Does Not Improve Survival in Out-of-Hospital Cardiac Arrest

Administering sodium nitrite during resuscitation for out-of-hospital cardiac arrest does not improve survival, according to a study which appeared in JAMA. 

In this double-blind, placebo-controlled, phase II randomized control trial, researchers assessed just over 1,500 adults with out-of-hospital cardiac arrest from ventricular fibrillation or nonventricular fibrillation. The patients were randomized 1:1:1 to receive 45 mg of sodium nitrite (n = 500), 60 mg of sodium nitrite (n = 498), or placebo (n = 499), which was administered by paramedics during active resuscitation. The key endpoint was defined as survival to hospital admission.

According to the results, 41% of individuals in the 45 mg of sodium nitrite group and 43% in the 60 mg of sodium nitrite group juxtaposed to 44% in the placebo group survived to hospital admission. The researchers noted that none of the 7 prespecified secondary outcomes were significantly different, including survival to hospital discharge for 66 patients (13.2%) in the 45 mg of sodium nitrite group and 72 patients (14.5%) in the 60 mg of sodium nitrite group compared with 74 patients (14.9%) in the placebo group.

In this RCT, sodium nitrate did not improve survival to hospital admission vs placebo in patients with out-of-hospital cardiac arrest https://t.co/2nAgOzesqZ @Dezfulian_CCM @SayreMR @grahamnichol @UWashEM @UW #VisualAbstract

— JAMA (@JAMA_current) January 12, 2021

“Among patients with out-of-hospital cardiac arrest, administration of sodium nitrite, compared with placebo, did not significantly improve survival to hospital admission,” the researchers wrote in conclusion.

“These findings do not support the use of sodium nitrite during resuscitation from out-of-hospital cardiac arrest.”

In randomized trial, 45 or 60 mg IV nitrite therapy did not improve survival vs. placebo in patients w out of hospital cardiac arresthttps://t.co/HY0IoMJ2SF@JAMA @NIH

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— Graham Nichol (@grahamnichol) January 12, 2021

Congratulations to my colleagues @UWashEM @UWCardiology @UWMedicine #UWashEMS on conducting this important prehospital trial in #OHCA. https://t.co/4AvQYhn5t5

— Nick Johnson (@NickJohnsonMD) January 12, 2021