The use of epinephrine in prehospital cardiac arrest showed no difference versus placebo in determining favorable neurological outcome according to a long awaited randomized controlled study published yesterday (July 18, 2018) in the New England Medical Journal.
The trial showed epinephrine produced a higher rate of survival at 30 days than placebo, but that was accompanied by almost twice the rate of severe neurological impairment.
Over 8,000 patients were enrolled in the randomized double-blind trial conducted in the United Kingdom between December of 2014 and October 2017.
The thirty day survival rate was 3.2% in the epinephrine group versus 2.4% in the placebo group. At hospital discharge 31% of the epinephrine survivors had severe neurological impairment versus 17.8% in the placebo group.
Paramedics needed to treat 112 patients with epinephrine in order to produce one extra survivor and that survivor was much more likely to have a poor neurological outcome than a placebo survivor.
The authors of an accompanying...
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