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Critical Care Reviews Podcast

COCA Trial - Viewer's Questions

Dec 6, 2021
Dr. Nutt asks Dr. Vallentin and Andersen viewers' questions about the COCA trial. They discuss the usage, timing, and dosage of calcium in cardiac arrest, as well as the timing of adrenaline administration and the difference between IV and IO administration of calcium.
12:00

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Quick takeaways

  • The COCA trial results indicate that calcium should no longer be used in cardiac arrest due to potential harm and differences in observed rhythms.
  • The COCA trial administered calcium early in resuscitation based on European guidelines and ALS algorithm recommendations, but did not test the effect of slow administration.

Deep dives

Decision to Stop Using Calcium in Cardiac Arrest

In this podcast episode, the speaker discusses the decision to stop using calcium in cardiac arrest. The general consensus is that calcium should no longer be used in cardiac arrest due to the findings of the study. The data showed a low event rate and differences in the types of rhythms observed between the calcium and non-calcium groups. Although the adjusted analysis attenuated the results, there was still a signal towards harm. The decision not to have predefined stopping criteria was deliberate, allowing examination of secondary outcomes and adverse events.

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