Abstract
Background
Sudden cardiac arrest accounts for approximately 15% of deaths in developed nations,
with poor survival rate. The American Heart Association states that epinephrine is
reasonable for patients with cardiac arrest, though the literature behind its use
is not strong.
Objective
To review the evidence behind epinephrine for cardiac arrest.
Discussion
Sudden cardiac arrest causes over 450,000 deaths annually in the United States. The
American Heart Association recommends epinephrine may be reasonable in patients with
cardiac arrest, as part of Advanced Cardiac Life Support. This recommendation is partly
based on studies conducted on dogs in the 1960s. High-dose epinephrine is harmful
and is not recommended. Epinephrine may improve return of spontaneous circulation,
but does not improve survival to discharge or neurologic outcome. Literature suggests
that three phases of resuscitation are present: electrical, circulatory, and metabolic.
Epinephrine may improve outcomes in the circulatory phase prior to 10 min post arrest,
though further study is needed. Basic Life Support measures including adequate chest
compressions and early defibrillation provide the greatest benefit.
Conclusions
Epinephrine may improve return of spontaneous circulation, but it does not improve
survival to discharge or neurologic outcome. Timing of epinephrine may affect patient
outcome, but Basic Life Support measures are the most important aspect of resuscitation
and patient survival.
Keywords
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Article info
Publication history
Published online: February 04, 2017
Accepted:
December 22,
2016
Received:
December 6,
2016
Footnotes
This review does not reflect the opinions or views of the U.S. government, Department of Defense, or U.S. Air Force.
Identification
Copyright
Published by Elsevier Inc.
