Abstract P155: Efficacy of Intravenous Adrenaline Administration in Patients with Out-of-Hospital Cardiac Arrest
Background: Adrenaline has been routinely administered to patients who receive cardiopulmonary resuscitation (CPR); however, its effects on outcomes remain unclear. Since April 2006, emergency medical technicians (EMTs) have been able to administer intravenous adrenaline to patients before arrival at the hospital in Japan. At present, some EMTs are qualified to administer intravenous adrenaline to patients, while the others are not. It is therefore an optimal time to compare the outcomes of patients with out-of-hospital cardiac arrest (OHCA) according to whether they had received intravenous adrenaline before admission.
Methods: This was a multicenter retrospective study. Of 7202 patients who were admitted to 12 hospitals in Yokohama because of OHCA from April 2006 through October 2008, we studied 723 patients in whom an EMT secured peripheral venous pathways before hospital admission. Patients were divided into two groups: those in whom adrenaline was given intravenously before admission by an EMT qualified to administer intravenous adrenaline (adrenaline group) and those in whom intravenous adrenaline was not given because the EMT was unqualified (non-adrenaline group). The outcomes (prehospital return rate of spontaneous circulation, hospital admission rate of survivors, survival rate at 1 month, and rate of favorable neurologic recovery) were compared between the groups.
Results: The return rate of spontaneous circulation before arrival at the hospital (11% vs. 6%, p=0.01) and the hospital admission rate among the survivors (36% vs. 25%, p<0.01) differed significantly between the adrenaline group (N=351) and the non-adrenaline group (N=372). However, the survival rate at 1 month (3% vs. 3%, p=0.80) and the rate of favorable neurologic recovery did not differ significantly between the groups (1% vs. 2%, p=0.13).
Conclusion: Intravenous adrenaline administration before arrival at the hospital can improve short-term outcomes in patients with OHCA, but did not increase the frequency of neurological outcome.