Effects of prehospital epinephrine administration on neurological outcomes in patients with out-of-hospital cardiac arrest


Just released online a retrospective study of prehospital epinephrine/adrenaline on neurologic outcomes in OHCA! Showing benefit in sub group with CPR 15-19 min duration

Read and decide for yourself!

Effects of prehospital epinephrine administration on neurological outcomes in patients with out-of-hospital cardiac arrest

Editor’s opinion: I have always believed epinephrine has a role in cardiac arrest. This study indicates that for short cardiac arrest times it adds little to outcomes which makes sense considering the other resuscitation evidence. It also indicates the longer the arrest time the worse outcomes. Once again totally logical. What it adds is more evidence refuting past studies that neurologic outcomes improve if shorter arrest times and improved ROSC. This is very logical to me.

  1. Just a concern about multiple administration of Epi. In our experience, patients who received multiple doses of epi (more than 5?) and have a ROSC, most of the time develop intestinal ischemia, in particular those ones who benefit from external cardiac life support protocol. It makes sense for me cause such a great dose of vasopressors in such a low metabolic status tend to be accumulated, and when a perfusion is restored arrives to the tissues provoking a violent vasoconstriction. That’s why we recommend our professionals to limitate epi to a max of 5 mg despite the resuscitation time. Does this make sense for you? Have you any other experience on that?

  2. Hey Minh I’m glad studies like this are being performed more and more, but we can’t say the epinephrine had anything to do with the success in this group since they didn’t have a group in the same time frame that they didn’t give epi to. The time frame alone, or the way they resuscitated the PTs could have everything to do with the increased success with this group. Again more questions than answers.

    • Thanks Matt
      I think it shows an association with better outcomes . Not causal but it is the same signal seen in Jacobs RCT
      We await PARAMEDIC2 results

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