Epinephrine May Be of No Survival Benefit in Cardiac Arrest

Standard advanced cardiac life support guidelines recommend administration of epinephrine at a dose of 1 mg every 3 to 5 minutes, but is there evidence that this therapy improves outcomes? To answer this question, researchers performed a meta-analysis of 14 randomized, controlled trials (12,250 total patients) in nine countries that compared standard-dose epinephrine with high-dose epinephrine (>1 mg per dose), vasopressin, or placebo in adults with out-of-hospital cardiac arrest.

Rates of survival to hospital admission and return of spontaneous circulation were higher with high-dose epinephrine than with the standard dose and were lower with placebo than with the standard dose. However, there were no differences in survival to discharge or …