Abstract 228: Epinephrine Does Not Increase the Likelihood of Recurrent Ventricular Fibrillation in Witnessed Out Of Hospital Cardiac Arrest
Introduction: Patients with out of hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF) may require repeat shocks for either persistent, shock resistant VF that fails to defibrillate with prior shocks, or VF that is recurrent after a prior successful defibrillation shock. Epinephrine is commonly administered and it is unknown if this medication contributes to the likelihood of VF recurrence.
Methods: Patients with witnessed OHCA and VF as the initial rhythm were included in this study. The arrest logs were analyzed for timing of epinephrine administration relative to defibrillation shocks. VF was categorized as either recurrent (following a preceding successful defibrillation shock) or shock resistant, (following a preceding failed defibrillation). A shock was regarded as occurring in the presence of epinephrine if that drug had been administered at any time prior to that shock. Logistic regression, with random effects to account for repeated shocks in the same subject, was used to determine if the administration of epinephrine predicted VF recurrence.
Results: 33 subjects were analyzed who required more than one shock during resuscitation. 72 shocks were delivered for shock resistant VF and 63 shocks for recurrent VF, and epinephrine was administered (range 1 to 4 dosages) to 27 subjects. The proportion of shocks delivered after epinephrine administration was 79% for shock resistant VF and 70% for recurrent VF; epinephrine administration did not predict VF recurrence (P=0.6 by logistic regression).
Conclusions: The administration of epinephrine during resuscitation for witnessed OHCA due to VF is not predictive of the recurrence of VF.
- © 2010 by American Heart Association, Inc.