Key result
Markedly lower arrival serum epinephrine linked to achieving ROSC in VF OHCA.
Why the study?
Epinephrine is the first choice as a vasoconstrictor in CPR for cardiopulmonary arrest, but the serum epinephrine concentration in these patients remains unclear.
Are serum epinephrine levels associated with achieving return of spontaneous circulation in out-of-hospital cardiac arrest patients with ventricular fibrillation?
Observational (n=17)
No
Are serum epinephrine levels associated with achieving return of spontaneous circulation in out-of-hospital cardiac arrest patients with ventricular fibrillation?
In out-of-hospital cardiac arrest patients with ventricular fibrillation, higher serum epinephrine and norepinephrine levels upon hospital arrival are associated with a failure to achieve return of spontaneous circulation.
Answers are grounded in this paper and cite their sources.
Epinephrine levels on arrival may aid ROSC prediction in VF-OHCA; hypothesis-generating and should not change practice yet.
Background and objective Epinephrine (Ep) is the first choice as a vasoconstrictor in cardiopulmonary resuscitation (CPR) for patients with cardiopulmonary arrest (CPA); however, the Ep concentration in the serum of CPA patients is still unclear. The aim of this study was to evaluate the association between serum Ep levels and achieving the return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) patients with ventricular fibrillation (VF). Methods This was a prospective, observational clinical study involving OHCA patients with VF transferred to our hospital from July 2014 to July 2017. The measurement of serum catecholamines [Ep, norepinephrine (Nep), and dopamine (DOA)] and vasopressin [antidiuretic hormone (ADH)] levels was performed with blood samples obtained immediately upon patients' arrival at our hospital. Patients were classified into two groups: the ROSC(+) group and ROSC(-) group; the serum concentrations of catecholamines and ADH were compared between these two groups. Results The serum Ep and Nep levels were lower in the ROSC(+) group than those in the ROSC(-) group and the difference was statistically significant. On the other hand, no significant differences were found in serum DOA and ADH levels between the two groups. Conclusions The results of this study suggest that an increment in serum Ep levels does not promote achieving ROSC in OHCA patients with VF.
No takes yet. Share an insight, caveat, or question.
Oshima et al. (2023) conducted an observational in Out-of-hospital cardiac arrest with ventricular fibrillation (n=17). Serum epinephrine levels was evaluated on Serum epinephrine levels in patients achieving return of spontaneous circulation (ROSC+) versus those who did not (ROSC-) (p=0.002). Serum epinephrine levels measured immediately upon hospital arrival were significantly lower in out-of-hospital cardiac arrest patients with ventricular fibrillation who achieved ROSC compared to those who did not (median 0.50 vs 216.69 ng/ml, p=0.002).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: