Study Suggests Epinephrine for Cardiac Arrest May Be Harmful

Patients who receive epinephrine during resuscitation after cardiac arrest are less likely to survive with a good neurologic outcome, a study in the Journal of the American College of Cardiology suggests.

Researchers analyzed data from more than 1500 patients who were successfully resuscitated after an out-of-hospital cardiac arrest and were subsequently treated at a large Parisian hospital. Nearly three quarters received epinephrine during resuscitation; these patients were older, had a longer resuscitation, were less likely to have had a witnessed event, and were less likely to have had a shockable rhythm.
Overall, patients who received epinephrine were less likely to survive with a good neurologic outcome than those who did not receive epinephrine (17% vs. 60%).

The authors acknowledge the criticism that epinephrine could be “considered a surrogate marker of severity rather than an independent predictive factor” but say their “multiple methodological efforts” to remove bias led to their robust findings.

An editorialist writes that the study “adds to the concern that epinephrine is not the ideal vasopressor during resuscitation of patients.”