Effects of Epinephrine and Intravenous (I.V.) Needle on Cardiopulmonary Resuscitation (CPR) Outcome

Petter Andreas Steen

Status and phase: Completed; Phase 2

Conditions: Cardiac Arrest

Treatments: Device: Intravenous needle; Drug: Amiodarone; Drug: Atropine; Drug: Epinephrine

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT00121524

525-02201

Details and patient eligibility

About

Intravenous epinephrine has been part of the guidelines for cardiopulmonary resuscitation since the start. It improves outcome in animal studies, but has never been investigated in a controlled study in humans. Epidemiologic data indicate that it is an independent negative predictor for survival. If this is true in a controlled randomized study, it could be due to effects of the drug itself or more likely due to reduced quality of chest compressions and ventilations due to the time spent on placing an I.V. needle and injecting drugs.

Full description

In a randomized, controlled study of all out-of-hospital cardiac arrest patients in Oslo, Norway, half the patients are treated according to the international guidelines for advanced CPR, and the other half according to the same guidelines, except for no I.V. needle or drugs are given until 5 minutes after eventual return of spontaneous circulation.

Enrollment: 904 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Cardiac arrest out-of-hospital

Exclusion criteria

• <18 years old
• Trauma as cause of arrest

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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904 participants in 2 patient groups

IV yes

Experimental group

Description:

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

Treatment:

Drug: Epinephrine

Drug: Atropine

Drug: Amiodarone

Device: Intravenous needle

IV no

No Intervention group

Description:

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.