A study claims that patients with an out-of-hospital cardiac arrest who received intravenous (IV) drug administration during treatment apparently had elevated rates of short term survival but no statistically considerable progress in survival to hospital discharge or long-term survival as opposed to patients who were not given IV drug administration.
The authors mentioned that intravenous access and drug administration are integral parts of cardiopulmonary resuscitation (CPR) guidelines. Millions of patients have received epinephrine during advanced cardiac life support (ACLS) with little or no evidence of improved survival to hospital discharge.
The authors commented, “Epinephrine was an independent predictor of poor outcome in a large epidemiological study, possibly due to toxicity of the drug or CPR interruptions secondary to establishing an intravenous line and drug administration.”
The consequnces for patients getting typical ACLS including and not including intravenous drug administration during out-of-hospital cardiac arrest in Oslo, between May 2003 and April 2008 were supposedly evaluated and matched by Theresa M. Olasveengen, M.D., of Oslo University Hospital, Norway, and colleagues. Out of about 1,183 patients for whom recovery was tried, around 851 were incorporated in the study and were categorized to either intervention. Roughly 418 patients were placed in the ACLS with intravenous drug administration group and approximately 433 were kept in the ACLS with no intravenous drug administration group. The principal result for the study was claimed to be survival to hospital discharge, with other outcomes counting 1-year survival and quality of CPR i.e. chest compression rate, pauses, and ventilation rate.
Investigation of the study outcomes signified that both groups apparently had sufficient and akin CPR quality, with some chest compression pauses and with compression and ventilation rates in the guideline recommendations.
The authors remarked, “In the intravenous group, 44 of 418 patients (10.5 percent) survived to hospital discharge vs. 40 of 433 (9.2 percent) in the no intravenous group. Survival with favorable neurological outcome was 9.8 percent for the intravenous group and 8.1 percent for the no intravenous group. The cumulative postcardiac arrest survival rate at 7 days was 14.6 percent for patients in the intravenous group vs. 12.8 percent for patients in the no intravenous group, 11.3 percent vs. 8.8 percent, respectively, at 1 month, and 9.8 percent vs. 8.4 percent at 1 year.”
The experts observed that post alteration for ventricular fibrillation, response interval, witnessed arrest, or arrest in a public place, there seemed to be no considerable difference in survival to hospital discharge for the intravenous group vs. the no intravenous group.
The study was published in JAMA.