What's the Best Dosing Interval for Epinephrine in Cardiac Arrest?

Guidelines advise giving epinephrine every 3 to 5 minutes during cardiac arrest, but there is no evidence to support this dosing frequency. To study the association between dosing intervals and outcome, researchers performed a secondary analysis of data from a large trial of chest-compression technique during out-of-hospital arrest. An average dosing interval was defined as the interval from first dose of epinephrine to the end of the resuscitation, divided by the total number of doses. Patients were stratified by these average intervals: <3 minutes, 3 to 4 minutes, 4 to 5 minutes, or >5 minutes. Patients who received <2 doses of epinephrine or whose timing of doses could not be calculated were excluded.

Of 26,148 patients in the trial, 15,9…