Abstract
AimThis study evaluated whether the prehospital administered dosage of epinephrine (Ep) influences the plasma levels of catecholamines in patients with out-of-hospital cardiac arrest (OHCA). MethodsThis was a prospective, observational clinical study. Patients with OHCA transferred to our hospital between July 2014 and July 2017 were analyzed. The plasma levels of catecholamines were measured using blood samples obtained immediately upon arrival at the hospital and before the administration of Ep. Patients were divided into three groups based on the prehospital administered dosage of Ep: no prehospital administration (group Z); 1 mg of Ep (group O); and 2 mg of Ep (group T). The levels of catecholamines, as well as the conditions of resuscitation prior to and after arrival at the hospital were compared between the three groups. ResultsWe analyzed 145 patients with OHCA (96, 38, and 11 patients in groups Z, O, and T, respectively). Group T exhibited the highest plasma levels of Ep with a statistically significant difference, however, there were no significant differences in the plasma levels of norepinephrine (Nep), dopamine (DOA) and vasopressin (ADH) among the three groups. ConclusionThe prehospital administered dosage of Ep influences the plasma levels of Ep; however, it does not contribute to the plasma levels of Nep, DOA and ADH in patients with OHCA.
Highlights
The efficacy of epinephrine (Ep) in patients with cardiopulmonary arrest (CPA) remains controversial [1, 2, 3, 4]
The 2020 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care Science With Treatment Recommendations strongly recommend the administration of Ep during CPR with low-to-moderate certainty of evidence [8, 9]
Tarnoky et al reported that the levels of catecholamines, including Ep and norepinephrine (Nep), in the plasma were significantly higher in the non-surviving animals in hemorrhagic shock models [10]
Summary
The efficacy of epinephrine (Ep) in patients with cardiopulmonary arrest (CPA) remains controversial [1, 2, 3, 4]. Perkins et al performed a randomized controlled trial (RCT) of Ep in adult patients with out-of-hospital cardiac arrest (OHCA) and reported that the use of Ep resulted in a significantly higher rate of 30-day survival than placebo. Tarnoky et al reported that the levels of catecholamines, including Ep and norepinephrine (Nep), in the plasma were significantly higher in the non-surviving animals in hemorrhagic shock models [10]. Lindner et al evaluated the plasma Ep levels in patients with OHCA and showed that, prior to the administration of Ep, they were significantly lower in resuscitated patients than non-resuscitated patients [11]. We previously reported that the plasma Ep levels prior to the administration of Ep were significantly lower in the ROSC (þ) group than the ROSC (À) group in patients with cardiogenic CPA [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
