Epinephrine in cardiac arrest
Annales Francaises de Medecine d'Urgence, ISSN: 2108-6591, Vol: 11, Issue: 4, Page: 235-241
2021
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Article Description
Epinephrine is recommended in international guidelines regarding the management of cardiac arrest. Even if daily used and indicated in algorithms for a long time, the level of evidence remains low. Pharmacological effects of epinephrine and side effects during cardiac arrest resuscitation may partly explain the debate about this treatment. Recent observational studies have highlighted this debate regarding the efficiency of this treatment when looking at the survival and neurological outcome after cardiac arrest. These findings warranted further randomized clinical trial focused on this concern. Recently, a large clinical trial compared epinephrine and placebo, underlining the benefit of this drug regarding the initial phase of resuscitation. However, a detrimental effect on long-term neurological recovery is still possible. In parallel, several ongoing studies investigate alternative strategies for epinephrine administration (timing, dosages), in order to improve its potential influence on different endpoints, including long-term neurological outcome. On the whole, even if epinephrine improves early survival after cardiac arrest, its role remains debated on late outcomes, including neurological recovery. However, in the absence of alternative drugs, epinephrine should not be abandoned and is still present in all advanced life support resuscitation guidelines.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85116145618&origin=inward; http://dx.doi.org/10.3166/afmu-2021-0335; https://afmu.revuesonline.com/10.3166/afmu-2021-0335; https://dx.doi.org/10.3166/afmu-2021-0335; https://afmu.revuesonline.com/articles/lvafmu/abs/2021/04/lvafmu_2021_sprurge001179/lvafmu_2021_sprurge001179.html
John Libbey Eurotext
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