Abstract
Aim
To investigate the influence of dosing frequency and dosage of adrenaline on outcomes
of cardiopulmonary resuscitation (CPR).
Methods
We conducted a retrospective observational study in a single medical centre and included
adult patients who had suffered an in-hospital cardiac arrest between 2006 and 2012.
We used multivariable logistic regression analysis to evaluate the associations between
independent variables and outcomes. Adrenaline average dosing frequency was calculated
as the total dosage of adrenaline administered during CPR divided by the duration
of CPR. Body weight (BW) was analysed as an interaction term to investigate the effect
of adrenaline dosage on outcomes. Favourable neurological outcome was defined as a
score of 1 or 2 on the Cerebral Performance Category scale at hospital discharge.
Results
We included 896 patients in the analysis. After adjusting for multiple confounding
factors, including CPR duration, the results indicated that higher adrenaline dosing
frequency was associated with lower rates of survival (odds ratio (OR): 0.05, 95%
confidence interval (CI): 0.01–0.23) and favourable neurological outcome at hospital
discharge (OR: 0.02, 95% CI: 0.002–0.16). A significant interaction was noted between
total adrenaline dosage and BW, which indicated that, with the same adrenaline dosage,
the outcomes for patients with BW ≥ 82.5 kg would be worse than those for patients with lower BW.
Conclusion
Higher adrenaline average dosing frequency may be associated with worse outcomes after
CPR. Besides, according to current recommendations, patients with BW above 82.5 kg may not receive adequate dose of adrenaline.
Keywords
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Article info
Publication history
Published online: December 29, 2015
Accepted:
December 16,
2015
Received in revised form:
November 16,
2015
Received:
August 22,
2015
Footnotes
☆A Spanish translated version of the summary of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2015.12.008.
Identification
Copyright
© 2015 Elsevier Ireland Ltd. All rights reserved.
