What do you expect to happen after administration of intravenous epinephrine during a resuscitation?

Arm Intervention/treatment
Experimental: IV yes

Intravenous needle Epinephrine q 3 min during CPR Atropine 3 mg in initial asystole Amiodarone 300 mg iv after repeated failed defibrillation attempts

Drug: Epinephrine

Epinephrine 1 mg is given iv. every 3 min during CPR


Device: Intravenous needle

An intravenous needle in placed as soon as possible during CPR


Drug: Atropine

Atropine 3 mg iv in initial systole

Other Name: Atropine sulfate


Drug: Amiodarone

amiodarone 300 mg iv after repeated failed defibrillation attempts


No Intervention: IV no

The patient will not have an intravenous needle placed or given any drugs during CPR. If patient obtains spontaneous circulation, an intravenous needle is placed and patient can receive any drugs that are appropriate during the following treatment.




Primary Outcome Measures :

  1. survival to hospital discharge with neurologic outcome [ Time Frame: discharge from hospital ]


Secondary Outcome Measures :

  1. admit to hospital with spontaneous circulation [ Time Frame: hospital admission ]
  2. one year survival with neurologic outcome [ Time Frame: one year after hospital discharge ]




Inclusion Criteria:

  • Cardiac arrest out-of-hospital

Exclusion Criteria:

  • <18 years old
  • Trauma as cause of arrest



Layout table for location information
Norway
Ulleval University Hospital
Oslo, Norway, N-0407

Ullevaal University Hospital

Health Region East, Norway

Norwegian Air Ambulance Foundation

Layout table for investigator information
Principal Investigator: Lars Wik, MD, PhD Ullevaal University Hospital

Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Keywords provided by Petter Andreas Steen, University of Oslo:

Additional relevant MeSH terms:

Layout table for MeSH terms
Heart Arrest
Heart Diseases
Cardiovascular Diseases
Atropine
Amiodarone
Epinephrine
Adrenergic alpha-Agonists
Adrenergic Agonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Adrenergic beta-Agonists
Bronchodilator Agents
Autonomic Agents
Peripheral Nervous System Agents
Anti-Asthmatic Agents
Respiratory System Agents
Mydriatics
Sympathomimetics
Vasoconstrictor Agents
Adjuvants, Anesthesia
Anti-Arrhythmia Agents
Parasympatholytics
Muscarinic Antagonists
Cholinergic Antagonists
Cholinergic Agents
Vasodilator Agents
Potassium Channel Blockers
Membrane Transport Modulators



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Page 2

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From: Immediate intravenous epinephrine versus early intravenous epinephrine for in-hospital cardiopulmonary arrest

  All patients (n = 360) Epinephrine 0–1 min (n = 177) Epinephrine ≥ 2 min (n = 183) P-value
Median age in years (IQR) 62 (26) 62 (25.50) 62 (25) 0.90
Male n(%) 220 (61.1%) 113 (63.8%) 107 (58.5%) 0.29
Female n(%) 140 (38.9%) 64 (36.2%) 76 (41.5%)
Saudi Arabian 194 (53.9%) 94 (53.1%) 100 (54.6%) 0.77
Non-Saudi 166 (46.1%) 83 (46.9%) 83 (45.4%)
Median CPR duration in minutes (IQR) 20:00 (16:45) 16:00 (15:00) 20:00 (15:00) 0.70
Median epinephrine time in minutes (IQR) 2:00 (3) 0:00 (0) 3:00 (3) < 0.01
PEA n(%) 132 (36.7%) 95 (53.7%) 37 (20.2%) < 0.01
Asystole n(%) 228 (63.3%) 82 (46.3%) 146 (79.8%)
Intubation during CPR n(%) 199 (55.3%) 94 (53.1%) 105 (57.4%) 0.41
No intubation during CPR n(%) 161 (44.7%) 83 (46.9%) 78 (42.6%)
ROSC n(%) 95 (26.4%) 55 (31.1%) 40 (21.9%) 0.04
Respiratory n(%) 132 (36.7%) 53 (29.9%) 79 (43.2%) < 0.01
Cardiac n(%) 95 (26.4%) 60 (33.9%) 35 (19.1%)
CNS n(%) 48 (13.3%) 22 (29.9%) 26 (14.2%)
Metabolic n(%) 43 (11.9%) 26 (14.7%) 17 (9.3%)
GI n(%) 43 (11.7%) 16 (9.0%) 26 (14.2%)
ICU n(%) 172 (47.8%) 83 (46.9%) 89 (48.6%) 0.01
ED n(%) 117 (32.5%) 68 (38.4%) 49 (26.8%)
Floor n(%) 71 (19.7%) 26 (14.7%) 45 (24.6%)
Hospital A n(%) 168 (46.7%) 76 (42.9%) 92 (50.3%) 0.10
Hospital B n(%) 98 (27.2%) 46 (26.0%) 52 (28.4%)
Hospital C n(%) 94 (26.1%) 55 (31.1%) 39 (21.3%)