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Is there a role for adrenaline during cardiopulmonary resuscitation?

Nolan, Jerry P.a; Perkins, Gavin D.b

Current Opinion in Critical Care: June 2013 - Volume 19 - Issue 3 - p 169–174
doi: 10.1097/MCC.0b013e328360ec51
CARDIOPULMONARY RESUSCITATION: Edited by Jerry P. Nolan

Purpose of review: To critically evaluate the recent data on the influence adrenaline has on outcome from cardiopulmonary resuscitation.

Recent findings: Two prospective controlled trials in out-of-hospital cardiac arrest (OHCA) have indicated that adrenaline increases the rate of return of spontaneous circulation (ROSC), but neither was sufficiently powered to determine the long-term outcomes. Several observational studies document higher ROSC rates in patients receiving adrenaline after OHCA, but these also document an association between receiving adrenaline and worse long-term outcomes.

Summary: Appropriately powered prospective, placebo-controlled trials of adrenaline in cardiac arrest are essential if the role of this drug is to be defined reliably.

aRoyal United Hospital, Bath

bUniversity of Warwick, Heart of England NHS Foundation Trust, Coventry, UK

Correspondence to Jerry P. Nolan, FRCA, FCEM, FRCP, FFICM, Consultant in Anaesthesia and Intensive Care Medicine, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK. Tel: +44 1225 825056; e-mail: jerry.nolan@nhs.net

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins