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Effect of Epinephrine Administration in Out-of-Hospital Cardiac Arrest

Published online by Cambridge University Press:  08 April 2020

Ashish Kumar Open the ORCID record for Ashish Kumar [Opens in a new window] ,
Rajkumar Doshi  and
Mariam Shariff Open the ORCID record for Mariam Shariff [Opens in a new window]
Ashish Kumar*
Affiliation:
Department of Critical Care Medicine, St John’s Medical College Hospital, Bangalore, India
Rajkumar Doshi
Affiliation:
Department of Internal Medicine, University of Nevada Reno School of Medicine, Reno, Nevada, USA
Mariam Shariff
Affiliation:
Department of Critical Care Medicine, St John’s Medical College Hospital, Bangalore, India
*
Correspondence: Ashish Kumar, MBBS, Department of Critical Care Medicine, St John’s Medical College Hospital, Kormangala, Bangalore, India-560034, E-mail: [email protected]
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Abstract

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Keywords

epinephrineout-of-hospital cardiac arrestsurvival
Type
Letter to the Editor
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 3 , June 2020 , pp. 351
Copyright
© World Association for Disaster and Emergency Medicine 2020

Sir,

We read with interest a meta-analysis published in Prehospital and Disaster Medicine titled “The Effect of Prehospital Epinephrine in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis.”Reference Ng and Teoh1 The authors included two randomized control trials totaling to 8,548 patients in the final analysis. We would like to congratulate the authors for their work. However, we have the following observation to make. Three studies titled: “Dynamic Effects of Adrenaline (Epinephrine) in Out-of-Hospital Cardiac Arrest with Initial Pulseless Electrical Activity (PEA)” by Nordseth, etal;Reference Nordseth, Olasveengen, Kvaløy, Wik, Steen and Skogvoll2 “Intravenous Drug Administration During Out-of-Hospital Cardiac Arrest, A Randomized Trial” by Olasveengen, etal;Reference Olasveengen, Sunde, Brunborg, Thowsen, Steen and Wik3 and “High Dose and Standard Dose Adrenaline do not Alter Survival, Compared with Placebo, in Cardiac Arrest” by Woodhouse, etalReference Woodhouse, Cox, Boyd, Case and Weber4 were randomized control trials studying the effect of epinephrine administration on out-of-hospital cardiac arrest as compared to placebo. The authors have excluded these studies from the final analysis in the present meta-analysis. Since these studies have contradicting results, their inclusion in the final analysis may alter the final conclusion of the meta-analysis.

Conflicts of interest

Authors have nothing to disclose.

References

Ng, KT, Teoh, WY. The effect of prehospital epinephrine in out-of-hospital cardiac arrest: a systematic review and meta-analysis. Prehosp Disaster Med. 2019;34(5):532–539.CrossRefGoogle ScholarPubMed
Nordseth, T, Olasveengen, TM, Kvaløy, JT, Wik, L, Steen, PA, Skogvoll, E. Dynamic effects of adrenaline (epinephrine) in out-of-hospital cardiac arrest with initial pulseless electrical activity (PEA). Resuscitation. 2012;83(8):946–952.CrossRefGoogle Scholar
Olasveengen, TM, Sunde, K, Brunborg, C, Thowsen, J, Steen, PA, Wik, L. Intravenous drug administration during out-of-hospital cardiac arrest: a randomized trial. JAMA. 2009;302(20):2222–2229.CrossRefGoogle ScholarPubMed
Woodhouse, SP, Cox, S, Boyd, P, Case, C, Weber, M. High dose and standard dose adrenaline do not alter survival, compared with placebo, in cardiac arrest. Resuscitation. 1995;30(3):243–249.CrossRefGoogle Scholar