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Safety of Epinephrine in Cardiac Arrest Questioned

Posted on Sun, Dec 14, 2014

Tied to risk of brain damage, with greater risk at higher doses

TUESDAY, Dec. 2, 2014 (HealthDay News) -- Four out of five people who receive epinephrine to restart their heart end up suffering significant damage to brain function, and the risk increases with the dose. These findings were published in the Dec. 9 issue of the Journal of the American College of Cardiology.

French researchers analyzed hospital records for 1,556 people admitted to a large Paris hospital over 12 years. All had suffered cardiac arrest outside a hospital but had been resuscitated. Nearly three-quarters (73 percent) had received at least one dose of epinephrine. The researchers focused on people who left the hospital with normal or only moderately compromised brain function as a result of their cardiac arrest. They found that 63 percent of patients who did not receive epinephrine left with relatively healthy brains, compared to 17 percent of those who got one or more shots of epinephrine.

Patients receiving higher doses of epinephrine fared worse than those with lower doses, the investigators found. Compared to patients who received no epinephrine, those receiving 1-mg doses were 52 percent more likely to suffer brain damage, and those receiving 5-mg or larger doses were 77 percent more likely. Timing also proved a factor, with patients more likely to have a bad outcome if they received epinephrine later in their resuscitation.

"The role of epinephrine is more and more questionable in cardiac arrest," study lead author Florence Dumas, M.D., Ph.D., of the Parisian Cardiovascular Research Center, said in a journal news release. "We need to constantly assess our procedures and protocols to make sure that the use of epinephrine is effective and done at the correct time."

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