Epinephrine, the standard care in cardiac arrest in ACLS. Does it increase survival and improve neurological outcomes?
| dc.contributor.author | Persad, Vishnu | |
| dc.date.accessioned | 2019-10-21T17:37:40Z | |
| dc.date.available | 2019-10-21T17:37:40Z | |
| dc.date.issued | 2019 | |
| dc.date.submitted | 2019-10-21T17:37:40Z | en |
| dc.description.abstract | Background: During cardiopulmonary resuscitation (CPR), epinephrine administered intravenously every 3-5 minutes is the recommended drug of choice per ACLS guidelines determined by the International Liaison Committee on Resuscitation (ILCOR), citing greater likelihood of ROSC (1)(2)(3). However, recent evidence implies there may be impaired neurological outcomes when administering epinephrine to cardiac arrest patients out of hospital (3)(4). Objective: To evaluate if epinephrine has the ability to increase return of spontaneous circulation, increase survival to discharge, and promote functional neurological outcomes in patients who sustain an out of hospital cardiac arrest event. Furthermore, to determine whether initial cardiac rhythms during cardiac arrest respond differently to epinephrine administration. Methods A literature review of randomized controlled trials was conducted using PubMed, Google Scholar and Cochrane Library databases. Key words used include but were not limited to: cardiac arrest, epinephrine, adrenaline, and out of hospital cardiac arrest. A total of 15 5 were selected based on inclusion criteria. Results: Three of the five RCTs demonstrated an increased likelihood for ROSC however there was conflicting results as to whether epinephrine increased survival to discharge. One RCT found epinephrine administration worsened neurological outcomes. There were inconsistent findings to discern whether different cardiac arrest rhythms respond differently to epinephrine administration. Conclusion: The justification of epinephrine’s use in ACLS is based on inconsistent data limited to trials with small enrollment. Further large scale high quality RCTs are needed to determine whether help or harm is being done to patients are in imminent danger of death. | en_US |
| dc.identifier.uri | http://hdl.handle.net/1993/34339 | |
| dc.rights | open access | en_US |
| dc.subject | Epinephrine | en_US |
| dc.subject | CPR | en_US |
| dc.subject | Cardiopulmonary resuscitation | en_US |
| dc.subject | Cardiac arrest | en_US |
| dc.title | Epinephrine, the standard care in cardiac arrest in ACLS. Does it increase survival and improve neurological outcomes? | en_US |
| dc.type | master thesis | en_US |