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© Fabrice Chrétien with Ultrapole, colorized by Jean-Marc Panaud
Cellule souche (en jaune) de muscle squelettique partiellement recouverte par la membrane basale, migrant sur une fibre musculaire (en bleu).
Publication : Journal of the American College of Cardiology

Is epinephrine during cardiac arrest associated with worse outcomes in resuscitated patients?

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Journal of the American College of Cardiology - 01 Dec 2014

Dumas F, Bougouin W, Geri G, Lamhaut L, Bougle A, Daviaud F, Morichau-Beauchant T, Rosencher J, Marijon E, Carli P, Jouven X, Rea TD, Cariou A

Link to Pubmed [PMID] – 25465423

J. Am. Coll. Cardiol. 2014 Dec;64(22):2360-7

BACKGROUND: Although epinephrine is essential for successful return of spontaneous circulation (ROSC), the influence of this drug on recovery during the post-cardiac arrest phase is debatable.

OBJECTIVES: This study sought to investigate the relationship between pre-hospital use of epinephrine and functional survival among patients with out-of-hospital cardiac arrest (OHCA) who achieved successful ROSC.

METHODS: We included all patients with OHCA who achieved successful ROSC admitted to a cardiac arrest center from January 2000 to August 2012. Use of epinephrine was coded as yes/no and by dose (none, 1 mg, 2 to 5 mg, >5 mg). A favorable discharge outcome was coded using a Cerebral Performance Category 1 or 2. Analyses incorporated multivariable logistic regression, propensity scoring, and matching methods.

RESULTS: Of the 1,556 eligible patients, 1,134 (73%) received epinephrine; 194 (17%) of these patients had a good outcome versus 255 of 422 patients (63%) in the nontreated group (p 5 mg of epinephrine. Delayed administration of epinephrine was associated with worse outcome.

CONCLUSIONS: In this large cohort of patients who achieved ROSC, pre-hospital use of epinephrine was consistently associated with a lower chance of survival, an association that showed a dose effect and persisted despite post-resuscitation interventions. These findings suggest that additional studies to determine if and how epinephrine may provide long-term functional survival benefit are needed.

http://www.ncbi.nlm.nih.gov/pubmed/25465423