Key result
Substantially lower pre-dose epinephrine levels linked to achieving ROSC.
Why the study?
There remains controversy regarding the efficacy of epinephrine in patients with cardiopulmonary arrest and the importance of plasma catecholamine levels prior to epinephrine administration is unclear.
Are endogenous plasma catecholamine levels associated with the return of spontaneous circulation in patients with cardiogenic out-of-hospital cardiac arrest?
Population
48 cardiogenic OHCA patients not treated with epinephrine prior to blood sampling
Comparison
ROSC (+) group vs ROSC (-) group based on return of spontaneous circulation
Design
Prospective observational study at a single center
Authors
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High endogenous epinephrine before dosing was associated with failed ROSC in cardiogenic OHCA; hypothesis-generating and requires prospective validation.
Observational (n=48)
No
Are endogenous plasma catecholamine levels associated with the return of spontaneous circulation in patients with cardiogenic out-of-hospital cardiac arrest?
Absolute Event Rate: 0.34% vs 2.28%
p-value: p=0.002
Increased endogenous plasma levels of epinephrine and norepinephrine prior to exogenous administration may be negatively associated with achieving ROSC in cardiogenic OHCA.
Oshima et al. (2019) conducted an observational in Cardiogenic out-of-hospital cardiac arrest (n=48). Return of spontaneous circulation (ROSC) vs. No return of spontaneous circulation (ROSC-) was evaluated on Plasma epinephrine level prior to epinephrine administration (ng/mL) (p=0.002). Plasma levels of epinephrine prior to epinephrine administration were significantly lower in patients who achieved return of spontaneous circulation compared to those who did not (0.34 vs 2.28 ng/mL, p=0.002).
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