Resuscitation
-
Epinephrine has been recommended for several decades for the treatment of cardiac arrest. However, although this potent medicament has a documented impact on the return of spontaneous circulation, it does not improve long-term survival. Decreased cerebral blood flow, one of the side effects of epinephrine, indicates that the use of this drug is a two-edged sword. Despite clinical recommendations, no study has investigated epinephrine pharmacokinetics in a setting of cardiac arrest. Therefore, in a pilot setting, we measured the plasma concentrations of epinephrine following a single administration. ⋯ Our study indicates that elimination of epinephrine during cardiac arrest is prolonged and that repeated doses of epinephrine may lead to increased plasma levels. Further and larger studies are warranted to determine the optimal plasma concentration during resuscitation.
-
The epidemiology and outcomes for patients with an out-of-hospital cardiac arrest (OHCA) caused by poisoning are largely unknown and may differ from OHCA of other causes. The study's aim is to compare key characteristics and outcomes between OHCA caused by poisoning vs. other causes. ⋯ Patients with an OHCA caused by poisoning were younger, a larger proportion of men and had several predictors for increased mortality, yet still had a lower 30-day mortality rate when compared to other causes.