Key result
Prehospital epinephrine improves ROSC in OHCA but fails to improve survival to discharge or neurological outcomes.
Why the study?
The effect of prehospital epinephrine on long-term morbidity and mortality after out-of-hospital cardiac arrest was unclear.
Does prehospital epinephrine improve long-term morbidity or mortality in patients with out-of-hospital cardiac arrest?
Does prehospital epinephrine improve long-term morbidity or mortality in patients with out-of-hospital cardiac arrest?
Prehospital epinephrine in out-of-hospital cardiac arrest improves initial resuscitation metrics like ROSC but fails to improve meaningful clinical outcomes such as survival to discharge or neurological recovery.
Epinephrine may aid initial resuscitation without improving discharge survival or neurology in OHCA; leaves open optimal protocols for future trials.
A short-cut review was carried out to establish whether prehospital adrenaline affects long-term morbidity or mortality after out-of-hospital cardiac arrest. Fifty-five papers were found using the reported search. Of these, three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that while epinephrine used as an adjunctive treatment during out-of-hospital cardiac arrest (OHCA) may improve return of spontaneous circulation (ROSC) and survival to hospital, it does not improve survival to discharge or neurological outcome.
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Evans et al. (2016) conducted a review in Out-of-hospital cardiac arrest. Epinephrine was evaluated on Survival to discharge or neurological outcome. Epinephrine used as an adjunctive treatment during out-of-hospital cardiac arrest may improve return of spontaneous circulation and survival to hospital, but does not improve survival to discharge or neurological outcome.
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