Adrenalin, The Heart Saviour
Treating cardiac arrests with adrenaline during resuscitation by paramedics slightly increases survival compared with placebo. Though adrenaline initially helped restore circulation in a third of cases, very little people survived to 30 days compared to other group. Severe brain damage was nearly twice as likely in those who survived after adrenaline injections.
Cardiac arrest occurs when the heart no longer pumps blood around the body, usually due to an irregular heart rhythm which can have a variety of causes including coronary heart disease.
This NIHR-funded trial of over 8000 people who had a cardiac arrest outside hospital provides high-quality UK-based evidence on the benefits and harms of adrenaline use during advanced cardiopulmonary resuscitation (CPR).
Due to the low overall survival rate, the jury is still out on whether adrenaline should be reserved for use in certain heart rhythms or within a particular time period and not for others. Early bystander recognition and CPR, plus early defibrillation probably have a greater impact on survival.
Adrenaline improved the return of spontaneous circulation and likelihood of survival to reach hospital but only slightly increased survival rates at a month. More of those survivors had severe neurological problems.
It remains unclear if out of hospital protocols should change as a result of this trial. The findings are also not able to inform hospital cardiac arrest protocols, as use of adrenaline typically occurs within three minutes of cardiac arrest.
Other studies of out of hospital cardiac arrest have shown better outcomes from prompt recognition, bystander CPR and defibrillation. Strategies to increase public training in CPR and make more defibrillators available may increase the number of people surviving out of hospital cardiac arrest.
Cardiac arrest occurs when the heart no longer pumps blood around the body, usually due to an irregular heart rhythm which can have a variety of causes including coronary heart disease.
This NIHR-funded trial of over 8000 people who had a cardiac arrest outside hospital provides high-quality UK-based evidence on the benefits and harms of adrenaline use during advanced cardiopulmonary resuscitation (CPR).
Due to the low overall survival rate, the jury is still out on whether adrenaline should be reserved for use in certain heart rhythms or within a particular time period and not for others. Early bystander recognition and CPR, plus early defibrillation probably have a greater impact on survival.
Adrenaline improved the return of spontaneous circulation and likelihood of survival to reach hospital but only slightly increased survival rates at a month. More of those survivors had severe neurological problems.
It remains unclear if out of hospital protocols should change as a result of this trial. The findings are also not able to inform hospital cardiac arrest protocols, as use of adrenaline typically occurs within three minutes of cardiac arrest.
Other studies of out of hospital cardiac arrest have shown better outcomes from prompt recognition, bystander CPR and defibrillation. Strategies to increase public training in CPR and make more defibrillators available may increase the number of people surviving out of hospital cardiac arrest.
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