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AHA: Early Epinephrine Administration in OHCA Beneficial

Last Updated: November 08, 2021.

MONDAY, Nov. 8, 2021 (HealthDay News) -- Earlier epinephrine treatment during an out-of-hospital cardiac arrest (OHCA) is associated with better recovery, according to a study presented at the American Heart Association Resuscitation Science Symposium 2021, to be held virtually from Nov. 12 to 14 as part of the annual meeting of the American Heart Association.

Shengyuan Luo, M.D., from the Rush University Medical Center in Chicago, and colleagues conducted a retrospective study in adults with shockable initial rhythm OHCA from 2011 to 2015 in North America. The associations between timing of epinephrine and prehospital return of spontaneous circulation (ROSC), survival to hospital discharge, and hospital discharge with favorable neurological outcome were examined. Data were included for 6,416 patients; 35 percent received epinephrine within four minutes after first defibrillation.

The researchers found that 80, 19, and 16 percent of participants had prehospital ROSC, survival to hospital discharge, and favorable neurological outcome at discharge, respectively. After adjustment for confounders, the odds of prehospital ROSC, survival to hospital discharge, and favorable neurological outcomes at discharge were lower per minute later epinephrine administration (odds ratios, 0.95, 0.91, and 0.92, respectively). The corresponding odds were also lower for later epinephrine compared with administration within four minutes following first defibrillation attempt (odds ratios, 0.58, 0.50, and 0.51, respectively). In a well-balanced propensity matched cohort and subgroup analyses, the associations remained significant.

"Our study's findings should guide emergency medical services professionals towards earlier administration of epinephrine during out-of-hospital cardiac arrest management," Luo said in a statement.

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