From JEMS:
Review Of: Jacobs I, Finn J, Jelinek G, et al. Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomized double-blind placebo-controlled trial. Resuscitation. 2011;82(9):1138–1143.
The Science: This is a randomized double blind, placebo control trial out of western Australia that looks at the effects of adrenaline (epinephrine) in prehospital cardiac arrest. The primary outcome to be measured was survival to hospital discharge, but the study also included a secondary analysis of return of spontaneous circulation (ROSC). Over the course of the study period, more than 4,000 patients were screened for eligibility, with a total of 534 patients being enrolled in the study: 262 in the placebo group vs. 272 in the control group (adrenaline). Investigators found those receiving adrenaline had 3.4 times great odds of achieving ROSC, and 2.2 great odds of survival to discharge.
However, the primary outcome of the study failed to reach statistical significance The investigators conclude the administration of adrenaline during out of hospital cardiac arrest increases the likelihood of achieving ROSC, but fails to demonstrate improved survival to hospital discharge.
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