Abstract
Purpose
The purpose of this systematic review is to provide up-to-date evidence on effectiveness
of antiarrhythmic drugs for shockable cardiac arrest to help inform the 2018 International
Liaison Committee on Resuscitation Consensus on Science with Treatment Recommendations.
Methods
A search was conducted in electronic databases Medline, Embase, and Cochrane Library
from inception to August 15, 2017.
Results
Of the 9371 citations reviewed, a total of 14 RCTs and 17 observational studies met
our inclusion criteria for adult population and only 1 observational study for pediatric
population. Based on RCT level evidence for adult population, none of the anti-arrhythmic
drugs showed any difference in effect compared with placebo, or with other anti-arrhythmic
drugs for the critical outcomes of survival to hospital discharge and discharge with
good neurological function. For the outcome of return of spontaneous circulation,
the results showed a significant increase for lidocaine compared with placebo (RR = 1.16;
95% CI, 1.03–1.29, p = 0.01).
Conclusion
The high level evidence supporting the use of antiarrhythmic drugs during CPR for
shockable cardiac arrest is limited and showed no benefit for critical outcomes of
survival at hospital discharge, survival with favorable neurological function and
long-term survival. Future high quality research is needed to confirm these findings
and also to evaluate the role of administering antiarrhythmic drugs in children with
shockable cardiac arrest, and in adults immediately after ROSC.
Keywords
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Article info
Publication history
Published online: September 01, 2018
Accepted:
August 23,
2018
Received in revised form:
August 17,
2018
Received:
June 28,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
