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Adrenaline use supported in patients during cardiac arrest
Jacobs I. Resuscitation. 2011;doi:10.1016/j.resuscitation.2011.06.029.
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The use of adrenaline improved the return of spontaneous circulation among patients experiencing cardiac arrest, but did not have a significant effect on survival to hospital discharge.
In all, researchers of the double blind, randomized study looked at 4,103 cardiac arrests in 534 patients (mean age, 65 years; 73% men) to determine the effect of adrenaline (n=272) compared with placebo (n=262).
Baseline characteristics were similar between both groups.
According to results, return of spontaneous circulation was reported in 23.5% of patients given adrenaline but only 8.4% who received placebo (OR=3.4; 95% CI, 2.0-5.6). Although survival to hospital discharge was also higher for patients receiving adrenaline (4% vs. 1.9%; OR=2.2; 95% CI, 0.7-6.3), the difference did not reach statistical significance. Also of note, patients given adrenaline were more likely to be admitted from the ED to the hospital (25.4% vs. 13%; OR=2.3; 95% CI 0.7-6.3).
“The findings of this study are clinically important in that it establishes efficacy for the continued use of adrenaline in cardiac arrest as currently recommended; however, numerous questions remain unanswered,” the researchers wrote. “Cardiac arrest is a disease entity that rapidly moves through a number of phases for which targeted interventions may further optimize survival. We have yet to determine the optimal dose or timing of adrenaline during cardiac arrest. This study provides an evidence base for current practice and a platform for ongoing research.”
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