Is there a role for adrenaline during cardiopulmonary resuscitation?

PURPOSE OF REVIEW: To critically evaluate the recent data on the influence adrenaline has on outcome from cardiopulmonary resuscitation. RECENT FINDINGS: Two prospective controlled trials in out-of-hospital cardiac arrest (OHCA) have indicated that adrenaline increases the rate of return of spontaneous circulation (ROSC), but neither was sufficiently powered to determine the long-term outcomes. Several observational studies document higher ROSC rates in patients receiving adrenaline after OHCA, but these also document an association between receiving adrenaline and worse long-term outcomes. SUMMARY: Appropriately powered prospective, placebo-controlled trials of adrenaline in cardiac arrest are essential if the role of this drug is to be defined reliably.