Effects of epinephrine for out-of-hospital cardiac arrest

Abstract

Abstract Aim: Our objective is to assess the effects of epinephrine for out of hospital cardiac arrest. Background: Cardiac arrest was the most serious medical incidents with an estimated incidence in the United States of 95.7 per 100,000 person years. Though epinephrine improved coronary and cerebral perfusion, improving a return of spontaneous circulation, potentially harmful effects on the heart lead to greater myocardial oxygen demand. Concerns about the effect of epinephrine for out-of-hospital cardiac arrest were controversial and called for a higher argument to determine whether the effects of epinephrine is safe and effective for shor and long terms outcomes. Method: Searching databases consist of all kinds of searching tools, such as Medline, the Cochrane Library, Embase, PubMed, etc. All the included studies should meet our demand of this meta-analysis. In the all interest outcomes blow we take the full advantage of STATA to assess, the main measure is Risk Ratio (RR) with 95% confidence, the publication bias are assessed by Egger Test. Result: In current systematic review and meta-analysis of randomized trials investigating epinephrine for out of hospital cardiac arrest, we found that epinephrine was associated with a significantly higher likelihood of ROSC (RR\u200a=\u200a3.05, I2\u200a=\u200a23.1%, P\u200a=\u200a.0001) and survival to hospital discharge (RR\u200a=\u200a1.40, I2\u200a=\u200a36.3%, P\u200a=\u200a.008) compared with non-adrenaline administration. Conversely, epinephrine did not increase CPC 1 or 2 (RR\u200a=\u200a1.15, I2\u200a=\u200a40.5%, P\u200a=\u200a.340) and hospital admission (RR\u200a=\u200a2.07, I2\u200a=\u200a88.2%, P\u200a=\u200a.0001). Conclusion: In conclusion, in this systematic review and meta-analysis involving studies, the use of epinephrine resulted in a significantly higher likelihood of survival to hospital discharge and ROSC than the non-epinephrine administration, but, there was no significant between group difference in the rate of a favorable neurologic outcome.