Effect of intravenous adrenaline before arrival at the hospital in out-of-hospital cardiac arrest

• Published in: Journal of cardiology Vol. 60; no. 6; pp. 503 - 507
• Main Authors: Machida, Minoru, MD, Miura, Shin-ichiro, MD, FJCC, Matsuo, Kunihiro, MD, Ishikura, Hiroyasu, MD, Saku, Keijiro, MD, FJCC
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2012
• Subjects: Adrenaline; Adult; Aged; Aged, 80 and over; Blood Circulation; Cardiac arrest; Cardiovascular; Epinephrine - administration & dosage; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Out-of-Hospital Cardiac Arrest - drug therapy; Out-of-Hospital Cardiac Arrest - mortality; Out-of-Hospital Cardiac Arrest - physiopathology; Out-of-Hospital Cardiac Arrest - rehabilitation; Patient Admission - statistics & numerical data; Patient Discharge - statistics & numerical data; Registries; Retrospective Studies; Return of spontaneous circulation; Survival Rate; Survival to discharge; Survival to hospital admission; Treatment Outcome; Young Adult; Survival to hospital admission; Survival to discharge; Return of spontaneous circulation; Adrenaline; Cardiac arrest
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2012.07.001

Abstract There is some evidence in prospective randomized clinical trials that the administration of adrenaline (AD) before admission for the treatment of out-of-hospital cardiac arrest did not improve survival to hospital discharge. The aim of this study was to evaluate our real-world experience regarding the efficacy of intravenous AD in out-of-hospital cardiac arrest at our university hospital. In this retrospective study, we enrolled and divided 644 patients into AD (AD administration before arrival at the hospital) and non-AD (no AD administration before arrival at the hospital) groups. The patient characteristics including age, sex, percentage of cardiac cause, location of cardiac arrest, and witnessed arrest were similar between the AD and non-AD groups. There were no significant differences between the AD and non-AD groups with regard to return of spontaneous circulation, survival to hospital admission, survival to hospital discharge, or good neurologic recovery at hospital discharge in all patients. In addition, we excluded the data of patients with extrinsic cause. We analyzed whether intravenous AD before arrival in patients with intrinsic cause was effective. The outcomes in the AD group were similar to those in the non-AD group. In conclusion, our study indicated that AD administration before arrival at the hospital for the treatment of out-of-hospital cardiac arrest did not improve the clinical outcome.