Adrenaline Use for Cardiac Arrest Reaffirmed

Cardiac arrest circulation restored with adrenaline

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Scientifically speaking, there has been limited evidence either for or against the use of adrenaline to indicate whether it is helpful in treating patients who have suffered cardiac arrest.

A new randomized placebo trial, however, shows the treatment is beneficial for cardiac arrest victims. Cardiac arrest occurs when normal blood circulation stops because of failure of the heart to contract effectively. It is most often caused by coronary artery disease.

"Ask your doctor about adrenaline if you are at risk for coronary artery disease."

Ian G. Jacobs, a lead researcher and Oxford-based professor, said that the study highlights the challenges of randomized cardiac arrest trials, particularly for a therapy that is accepted but unproven.

He said that although researchers were not able to show that adrenaline improves a patient's chance of surviving through to hospital discharge, it was found to increase the likelihood of restoring circulation following cardiac arrest.

The PACA (Placebo versus Adrenaline versus Cardiac Arrest) study will be published in journal Resuscitation.

During the double blind study, 601 out-of-hospital cardiac arrest victims at the same hospital randomly received either a placebo of sodium chloride or adrenaline during advanced life support. Data from 534 patients, including 272 who received adrenaline and 262 who were given the placebo, showed no difference in the number of patients who survived until hospital discharge.

However, the study did reveal that spontaneous circulation was restored, or the heart "restarted" three times more often with the use of adrenaline. Circulation was restored 23.5 percent of the time with adrenaline, and 8.4 percent of the time with the saline placebo.

This marks the first placebo controlled clinical trial that has shown a short-term survival benefit with the use of adrenaline.

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Review Date: 
July 26, 2011
Last Updated:
July 28, 2011