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The time dependent association of adrenaline administration and survival from out-of-hospital cardiac arrest.
Ewy, Gordon A; Bobrow, Bentley J; Chikani, Vatsal; Sanders, Arthur B; Otto, Charles W; Spaite, Daniel W; Kern, Karl B.
Afiliación
  • Ewy GA; Department of Medicine, University of Arizona Sarver Heart Center, Tucson, AZ, United States; Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, United States; Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, United States. Electronic addres
  • Bobrow BJ; Department of Medicine, University of Arizona Sarver Heart Center, Tucson, AZ, United States; Department of Emergency Medicine, University of Arizona College of Medicine, Phoenix, AZ, United States; Bureau of EMS and Trauma System, Arizona Department of Health Services, Phoenix, AZ, United States.
  • Chikani V; Bureau of EMS and Trauma System, Arizona Department of Health Services, Phoenix, AZ, United States.
  • Sanders AB; Department of Medicine, University of Arizona Sarver Heart Center, Tucson, AZ, United States; Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, AZ, United States; Department of Emergency Medicine, University of Arizona College of Medicine, Phoenix, AZ, United State
  • Otto CW; Department of Medicine, University of Arizona Sarver Heart Center, Tucson, AZ, United States; Department of Anesthesiology, University of Arizona College of Medicine, Tucson, AZ, United States; Department of Anesthesiology, University of Arizona College of Medicine, Phoenix, AZ, United States.
  • Spaite DW; Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, AZ, United States; Department of Emergency Medicine, University of Arizona College of Medicine, Phoenix, AZ, United States.
  • Kern KB; Department of Medicine, University of Arizona Sarver Heart Center, Tucson, AZ, United States; Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, United States; Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, United States.
Resuscitation ; 96: 180-5, 2015 Nov.
Article en En | MEDLINE | ID: mdl-26307453
BACKGROUND: Recommended for decades, the therapeutic value of adrenaline (epinephrine) in the resuscitation of patients with out-of-hospital cardiac arrest (OHCA) is controversial. PURPOSE: To investigate the possible time-dependent outcomes associated with adrenaline administration by Emergency Medical Services personnel (EMS). METHODS: A retrospective analysis of prospectively collected data from a near statewide cardiac resuscitation database between 1 January 2005 and 30 November 2013. Multivariable logistic regression was used to analyze the effect of the time interval between EMS dispatch and the initial dose of adrenaline on survival. The primary endpoints were survival to hospital discharge and favourable neurologic outcome. RESULTS: Data from 3469 patients with witnessed OHCA were analyzed. Their mean age was 66.3 years and 69% were male. An initially shockable rhythm was present in 41.8% of patients. Based on a multivariable logistic regression model with initial adrenaline administration time interval (AATI) from EMS dispatch as the covariate, survival was greatest when adrenaline was administered very early but decreased rapidly with increasing (AATI); odds ratio 0.94 (95% Confidence Interval (CI) 0.92-0.97). The AATI had no significant effect on good neurological outcome (OR=0.96, 95% CI=0.90-1.02). CONCLUSIONS: In patients with OHCA, survival to hospital discharge was greater in those treated early with adrenaline by EMS especially in the subset of patients with a shockable rhythm. However survival rapidly decreased with increasing adrenaline administration time intervals (AATI).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Epinefrina / Sistema de Registros / Reanimación Cardiopulmonar / Servicios Médicos de Urgencia / Paro Cardíaco Extrahospitalario Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Resuscitation Año: 2015 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Epinefrina / Sistema de Registros / Reanimación Cardiopulmonar / Servicios Médicos de Urgencia / Paro Cardíaco Extrahospitalario Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Resuscitation Año: 2015 Tipo del documento: Article Pais de publicación: Irlanda