Adrenaline for out-of-hospital cardiac arrest resuscitation: A systematic review and meta-analysis of randomized controlled trials

Lin, Steve; Callaway, Clifton W.; Shah, Prakesh S.; Wagner, Justin D.; Beyene, Joseph; Ziegler, Carolyn; Morrison, Laurie J.

doi:10.1016/j.resuscitation.2014.03.008

Cited by 146 publications

(102 citation statements)

References 52 publications

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“…Meta-analysis of trials which in total enrolled over 6000 patients found no improvement in outcomes compared to treatment with adrenaline (43,46), prompting the International Liaison Committee on Resuscitation (ILCOR) to recommend against its routine use in cardiac arrest (47).…”

Section: Ems Response and Interventions (Including Pharmacotherapeutimentioning

confidence: 99%

Out-of-hospital cardiac arrest: prehospital management

2018

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(no more than 150 words)Sudden out of hospital cardiac arrest is the most time critical medical emergency. In this expert opinion and literature review, we consider important issues in the pre-hospital management of cardiac arrest. Successful resuscitation is reliant on a strong chain of survival drawn from the community, dispatch center, ambulance and hospital working together. Early cardiopulmonary resuscitation and defibrillation has the greatest impact on survival. If the community response does not restart the heart, resuscitation is continued by emergency medical services staff. There is uncertainty about the best approaches for airway management and the effectiveness of current drug treatments. Prognostic factors and termination of resuscitation rules may guide the duration of a resuscitation attempt and decision to transport to hospital. If return of spontaneous circulation is achieved, the focus of treatment shifts to stabilization, restoring normal physiological parameters and transporting to hospital for on-going care.2

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Section: Ems Response and Interventions (Including Pharmacotherapeutimentioning

confidence: 99%

Out-of-hospital cardiac arrest: prehospital management

2018

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“…195 Administration of epinephrine during cardiac arrest has been accepted as a standard of care, but its use remains controversial; although epinephrine has been shown to improve ROSC, no improvement in long-term survival has yet been demonstrated. 196 Vasopressin has been used as an alternative, but trials comparing epinephrine to either vasopressin or placebo have failed to show superiority to hospital discharge or long-term survival. 194,197,198 Further clinical trials are needed on this topic, as all studies to date have been underpowered to draw conclusions with respect to survival outcomes.…”

Section: Defibrillationmentioning

confidence: 99%

Sudden cardiac death in the young

2017

Progress in Pediatric Cardiology

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Although the occurrence of sudden cardiac death (SCD) in a young person is a rare event, it is traumatic and often widely publicized. In recent years, SCD in this population has been increasingly seen as a public health and safety issue. This review presents current knowledge relevant to the epidemiology of SCD and to strategies for prevention, resuscitation and identification of those at greatest risk. Areas of active research and controversy include the development of best practices in screening, risk stratification approaches and post-mortem evaluation, and identification of modifiable barriers to providing better outcomes after resuscitation of young SCD victims. Institution of a national registry of SCD in the young will provide data that will help to answer these questions.

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“…5,6,25,47 Randomized studies and meta-analyses have shown increased rates of return of spontaneous circulation with epinephrine versus placebo or with high-dose versus standard-dose epinephrine, without an improvement in overall or neurologically intact survival with any dose of epinephrine. 28,48,49 Observational studies have associated the use of epinephrine and higher epinephrine doses with reduced rates of neurologically intact survival after outof-hospital cardiac arrest, raising concerns about the safety of epinephrine during ACLS. 26,27 More favorable outcomes might occur with earlier administration of epinephrine, which may facilitate early return of spontaneous circulation.…”

Section: Interventionsmentioning

confidence: 99%