For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
2
views
43
references
 Top references
cited by
6
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      396
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Early Administration of Adrenaline for Out‐of‐Hospital Cardiac Arrest: A Systematic Review and Meta‐Analysis

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          The use of adrenaline in out‐of‐hospital cardiac arrest (OHCA) patients is still controversial. This study aimed to determine the effects of early pre‐hospital adrenaline administration in OHCA patients.

          Methods and Results

          PubMed, EMBASE, Google Scholar, and the Cochrane Library database were searched from study inception to February 2019 to identify studies that reported OHCA patients who received adrenaline. The primary outcome was survival to discharge, and the secondary outcomes were return of spontaneous circulation, favorable neurological outcome, and survival to hospital admission. A total of 574 392 patients were included from 24 studies. The use of early pre‐hospital adrenaline administration in OHCA patients was associated with a significant increase in survival to discharge (risk ratio [RR], 1.62; 95% CI, 1.45–1.83; P<0.001) and return of spontaneous circulation (RR, 1.50; 95% CI, 1.36–1.67; P<0.001), as well as a favorable neurological outcome (RR, 2.09; 95% CI, 1.73–2.52; P<0.001). Patients with shockable rhythm cardiac arrest had a significantly higher rate of survival to discharge (RR, 5.86; 95% CI, 4.25–8.07; P<0.001) and more favorable neurological outcomes (RR, 5.10; 95% CI, 2.90–8.97; P<0.001) than non‐shockable rhythm cardiac arrest patients.

          Conclusions

          Early pre‐hospital administration of adrenaline to OHCA patients might increase the survival to discharge, return of spontaneous circulation, and favorable neurological outcomes.

          Registration

          URL: https://www.crd.york.ac.uk/PROSPERO; Unique identifier: CRD42019130542.

          Related collections

          Most cited references43

          • Record: found
          • Abstract: found
          • Article: not found

          A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest

          Kyee Han, Nigel Stallard, Stavros Petrou … (2018)
          Concern about the use of epinephrine as a treatment for out-of-hospital cardiac arrest led the International Liaison Committee on Resuscitation to call for a placebo-controlled trial to determine whether the use of epinephrine is safe and effective in such patients.
          Article 0 comments Cited 189 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Nationwide public-access defibrillation in Japan.

            Taku Iwami, Ken Nagao, Tetsuhisa Kitamura … (2010)
            It is unclear whether dissemination of automated external defibrillators (AEDs) in public places can improve the rate of survival among patients who have had an out-of-hospital cardiac arrest. From January 1, 2005, through December 31, 2007, we conducted a prospective, population-based, observational study involving consecutive patients across Japan who had an out-of-hospital cardiac arrest and in whom resuscitation was attempted by emergency responders. We evaluated the effect of nationwide dissemination of public-access AEDs on the rate of survival after an out-of-hospital cardiac arrest. The primary outcome measure was the 1-month rate of survival with minimal neurologic impairment. A multivariate logistic-regression analysis was performed to assess factors associated with a good neurologic outcome. A total of 312,319 adults who had an out-of-hospital cardiac arrest were included in the study; 12,631 of these patients had ventricular fibrillation and had an arrest that was of cardiac origin and that was witnessed by bystanders. In 462 of these patients (3.7%), shocks were administered by laypersons with the use of public-access AEDs, and the proportion increased, from 1.2% to 6.2%, as the number of public-access AEDs increased (P<0.001 for trend). Among all patients who had a bystander-witnessed arrest of cardiac origin and who had ventricular fibrillation, 14.4% were alive at 1 month with minimal neurologic impairment; among patients who received shocks from public-access AEDs, 31.6% were alive at 1 month with minimal neurologic impairment. Early defibrillation, regardless of the type of provider (bystander or emergency-medical-services personnel), was associated with a good neurologic outcome after a cardiac arrest with ventricular fibrillation (adjusted odds ratio per 1-minute increase in the time to administration of shock, 0.91; 95% confidence interval, 0.89 to 0.92; P<0.001). The mean time to shock was reduced from 3.7 to 2.2 minutes, and the annual number of patients per 10 million population who survived with minimal neurologic impairment increased from 2.4 to 8.9 as the number of public-access AEDs increased from fewer than 1 per square kilometer of inhabited area to 4 or more. Nationwide dissemination of public-access AEDs in Japan resulted in earlier administration of shocks by laypersons and in an increase in the 1-month rate of survival with minimal neurologic impairment after an out-of-hospital cardiac arrest. 2010 Massachusetts Medical Society
            Article 0 comments Cited 152 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial.

              John L P Thompson, J Finn, Heidi Jacobs … (2011)
              There is little evidence from clinical trials that the use of adrenaline (epinephrine) in treating cardiac arrest improves survival, despite adrenaline being considered standard of care for many decades. The aim of our study was to determine the effect of adrenaline on patient survival to hospital discharge in out of hospital cardiac arrest. We conducted a double blind randomised placebo-controlled trial of adrenaline in out-of-hospital cardiac arrest. Identical study vials containing either adrenaline 1:1000 or placebo (sodium chloride 0.9%) were prepared. Patients were randomly allocated to receive 1 ml aliquots of the trial drug according to current advanced life support guidelines. Outcomes assessed included survival to hospital discharge (primary outcome), pre-hospital return of spontaneous circulation (ROSC) and neurological outcome (Cerebral Performance Category Score - CPC). A total of 4103 cardiac arrests were screened during the study period of which 601 underwent randomisation. Documentation was available for a total of 534 patients: 262 in the placebo group and 272 in the adrenaline group. Groups were well matched for baseline characteristics including age, gender and receiving bystander CPR. ROSC occurred in 22 (8.4%) of patients receiving placebo and 64 (23.5%) who received adrenaline (OR=3.4; 95% CI 2.0-5.6). Survival to hospital discharge occurred in 5 (1.9%) and 11 (4.0%) patients receiving placebo or adrenaline respectively (OR=2.2; 95% CI 0.7-6.3). All but two patients (both in the adrenaline group) had a CPC score of 1-2. Patients receiving adrenaline during cardiac arrest had no statistically significant improvement in the primary outcome of survival to hospital discharge although there was a significantly improved likelihood of achieving ROSC. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
              Article 0 comments Cited 95 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Wei Huang:
                ORCID: https://orcid.org/0000-0002-2707-2165
                weihuangcq@gmail.com
                Journal
                Journal ID (nlm-ta): J Am Heart Assoc
                Journal ID (iso-abbrev): J Am Heart Assoc
                Journal ID (doi): 10.1002/(ISSN)2047-9980
                Journal ID (publisher-id): JAH3
                Journal ID (hwp): ahaoa
                Title: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2047-9980
                Publication date (Electronic): 04 June 2020
                Publication date Collection: 02 June 2020
                Volume: 9
                Issue: 11 ( doiID: 10.1002/jah3.v9.11 )
                Electronic Location Identifier: e014330
                Affiliations
                [ 1 ] Department of Orthopaedic Surgery and Orthopaedics Research Institute West China Hospital Sichuan University Chengdu China
                [ 2 ] Department of Cardiology First Affiliated Hospital Chongqing Medical University Chongqing China
                [ 3 ] Department of Emergency Medicine and Critical Care Medicine The First Affiliated Hospital of Chongqing Medical University Chongqing China
                [ 4 ] Department of EMS System Graduate School Kokushikan University Tokyo Japan
                [ 5 ] Emergency Medical Science Department Wake Technical Community College Raleigh NC
                Author notes
                [*] [* ]Correspondence to: Wei Huang, MD, PhD, Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China. E‐mail: weihuangcq@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-2707-2165
                Article
                Publisher ID: JAH35134
                DOI: 10.1161/JAHA.119.014330
                PMC ID: 7429014
                PubMed ID: 32441184
                SO-VID: 0ea3d270-8abd-4bac-94de-4aba8c80403b
                Copyright © © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date received : 19 August 2019
                Date accepted : 08 April 2020
                Page count
                Figures: 6, Tables: 1, Pages: 25, Words: 6238
                Funding
                Funded by: National Natural Science Foundation of China , open-funder-registry 10.13039/501100001809;
                Award ID: 81170188
                Award ID: 30971212
                Categories
                Subject: Systematic Review and Meta‐analysis
                Subject: Systematic Review and Meta‐analysis
                Custom metadata
                source-schema-version-number 2.0
                cover-date 02 June 2020
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.5 mode:remove_FC converted:19.07.2020

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: adrenaline,early pre‐hospital administration,out‐of‐hospital cardiac arrest,cardiopulmonary arrest,cardiopulmonary resuscitation and emergency cardiac care
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: adrenaline, early pre‐hospital administration, out‐of‐hospital cardiac arrest, cardiopulmonary arrest, cardiopulmonary resuscitation and emergency cardiac care

                Comments

                Comment on this article

                scite_

                Similar content396

                See all similar

                Cited by6

                See all cited by

                Most referenced authors1,271

                See all reference authors