A large observational study places added scrutiny on the use of epinephrine for out-of-hospital cardiac arrest.
A recent prospective, randomized, placebo-controlled trial of epinephrine for out-of-hospital cardiac arrest demonstrated that epinephrine increased the rate of return of spontaneous circulation but had no effect on survival to hospital discharge (JW Emerg Med Oct 14 2011). However, that study was underpowered. Researchers in Japan conducted a prospective observational propensity analysis of data for 417,188 out-of-hospital cardiac arrests in patients aged ≥18 years (mean age, 72) who were treated by emergency medical services and transported to a hospital from 2005 through 2008.
The odds of return of spontaneous circulation prior to hospital arrival were significantly higher in patients who received epinephrine in the field than in those wh…