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Administration of epinephrine increases return of spontaneous circulation in patients with cardiac arrest; however, whether it improves long-term neurological outcomes is unclear. Researchers reviewed Japan's nationwide Utstein registry to determine the effect of prehospital epinephrine in patients aged 15 to 94 with bystander-witnessed out-of-hospital medical cardiac arrest over a 3-year period. The study included 1990 pairs of propensity-score–matched patients with initial ventricular fibrillation/tachycardia (VF/VT) who received and did not receive epinephrine and 9058 such pairs with non-VF/VT.
Survival was better with prehospital epinephrine than without both in patients with VF/VT (17.0% vs. 13.4%) and in those with non-VF/VT (4.0% vs.…