Royal United Hospital, Bath, UK.
Curr Opin Crit Care. 2013 Jun;19(3):169-74. doi: 10.1097/MCC.0b013e328360ec51.
To critically evaluate the recent data on the influence adrenaline has on outcome from cardiopulmonary resuscitation.
Two prospective controlled trials in out-of-hospital cardiac arrest (OHCA) have indicated that adrenaline increases the rate of return of spontaneous circulation (ROSC), but neither was sufficiently powered to determine the long-term outcomes. Several observational studies document higher ROSC rates in patients receiving adrenaline after OHCA, but these also document an association between receiving adrenaline and worse long-term outcomes.
Appropriately powered prospective, placebo-controlled trials of adrenaline in cardiac arrest are essential if the role of this drug is to be defined reliably.
批判性评估肾上腺素对心肺复苏结局影响的最新数据。
两项院外心脏骤停（OHCA）的前瞻性对照试验表明，肾上腺素可提高自主循环恢复（ROSC）的速率，但两者都没有足够的效力来确定长期结局。几项观察性研究记录了在 OHCA 后接受肾上腺素治疗的患者中 ROSC 率较高，但这些研究也记录了接受肾上腺素治疗与长期预后较差之间的关联。
如果要可靠地确定这种药物的作用，就需要进行适当的、有安慰剂对照的肾上腺素在心脏骤停中的前瞻性试验。
