Key result
Early epinephrine administration during CPR for out-of-hospital cardiac arrest was associated with improved survival to hospital discharge and favorable functional outcome.
Why the study?
Does early epinephrine administration improve survival to hospital discharge and functional outcome in adults with out-of-hospital cardiac arrest?
Observational (n=40,000)
Yes
Does early epinephrine administration improve survival to hospital discharge and functional outcome in adults with out-of-hospital cardiac arrest?
Early administration of epinephrine during CPR for out-of-hospital cardiac arrest is associated with better survival and functional outcomes compared to later administration.
observed a time-dependent association between epinephrine administration and survival to hospital discharge and a favorable funtional outcome at discharge in adults with out-ofhospital cardiac arrest (OHCA) with an initial shockable (ventricular fibrillation/pulseless ventricular tachycardia) or nonshockable cardiac rhythm (pulseless electrical activity and asystole). Findings of the study suggest that if epinephrine is used during cardiopulmonary resuscitation (CPR) it is more likely to be beneficial if given early in the resuscitation attempt. The authors used a large data set (>40 000 patients from North America) and time-dependent propensity score-matching to limit resuscitation time bias. 2 During CPR, epinephrine treatment is more likely to occur as the duration of CPR increases, but the need for a longer CPR attempt is also associated with a worse outcome and can bias observations toward a harmful treatment effect from epinephrine. This risk of bias can be decreased by comparing patients who received epinephrine after a given number of minutes of resuscitation with similar patients who were at risk of receiving epinephrine in the same minute during their resuscitation (ie, ongoing CPR but not given epinephrine).
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Soar et al. (2021) conducted an observational in Out-of-hospital cardiac arrest (OHCA) (n=40,000). Early epinephrine administration vs. Later or no epinephrine administration was evaluated on Survival to hospital discharge and a favorable functional outcome at discharge. Early epinephrine administration during CPR for out-of-hospital cardiac arrest was associated with improved survival to hospital discharge and favorable functional outcome.
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