• B W Sherman, M A Munger, G E Foulke, W F Rutherford, and E A Panacek.
• Department of Medicine, Mt. Sinai Medical Center, Cleveland, Ohio, USA.
• Pharmacotherapy. 1997 Mar 1;17(2):242-7.

Study ObjectiveTo assess the efficacy of high-dose epinephrine (HDE) compared with standard-dose epinephrine (SDE) in emergency department patients in cardiac arrest after SDE failed to improve asystole or ventricular fibrillation.DesignProspective, multicenter, blinded, controlled trial.SettingEight academic center emergency departments.PatientsOne hundred forty patients treated for cardiac arrest.Measurements And Main ResultsPrimary outcomes were either improvement in cardiac rhythm or return of spontaneous circulation (ROSC). Of the 140 patients enrolled, 78 received HDE and 62 received SDE. Of the 34 patients with ventricular fibrillation, 3 were resuscitated with HDE and 2 with SDE (p = 0.60). Of those with asystole, ROSC occurred in 12 of HDE and 5 of SDE recipients (p = 0.11). No patient had return of significant neurologic function and none survived to hospital discharge. Overall, there was no advantage to HDE after failure of SDE.ConclusionOur results are similar to those of controlled clinical trials comparing HDE with SDE in cardiac arrest.

17 keywords...

hide…