Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, 814-0180, Japan.
J Cardiol. 2012 Dec;60(6):503-7. doi: 10.1016/j.jjcc.2012.07.001. Epub 2012 Aug 11.
There is some evidence in prospective randomized clinical trials that the administration of adrenaline (AD) before admission for the treatment of out-of-hospital cardiac arrest did not improve survival to hospital discharge. The aim of this study was to evaluate our real-world experience regarding the efficacy of intravenous AD in out-of-hospital cardiac arrest at our university hospital. In this retrospective study, we enrolled and divided 644 patients into AD (AD administration before arrival at the hospital) and non-AD (no AD administration before arrival at the hospital) groups. The patient characteristics including age, sex, percentage of cardiac cause, location of cardiac arrest, and witnessed arrest were similar between the AD and non-AD groups. There were no significant differences between the AD and non-AD groups with regard to return of spontaneous circulation, survival to hospital admission, survival to hospital discharge, or good neurologic recovery at hospital discharge in all patients. In addition, we excluded the data of patients with extrinsic cause. We analyzed whether intravenous AD before arrival in patients with intrinsic cause was effective. The outcomes in the AD group were similar to those in the non-AD group. In conclusion, our study indicated that AD administration before arrival at the hospital for the treatment of out-of-hospital cardiac arrest did not improve the clinical outcome.
有一些前瞻性随机临床试验的证据表明,在院外心脏骤停的治疗中,预先给予肾上腺素(AD)并不能提高出院时的生存率。本研究旨在评估我们在大学医院的真实世界中,AD 对院外心脏骤停的疗效。在这项回顾性研究中,我们招募并将 644 名患者分为 AD 组(AD 在到达医院前给药)和非 AD 组(AD 未在到达医院前给药)。AD 组和非 AD 组的患者特征,包括年龄、性别、心脏原因的比例、心脏骤停的位置和目击者骤停,在两组之间相似。在所有患者中,两组间自主循环恢复率、入院存活率、出院存活率或出院时良好的神经恢复率均无显著差异。此外,我们排除了因外在原因导致的患者数据。我们分析了内在原因的患者在到达医院前给予静脉内 AD 是否有效。AD 组的结果与非 AD 组相似。总之,我们的研究表明,在院外心脏骤停的治疗中,预先给予 AD 并不能改善临床结局。