Review article
https://doi.org/10.64266/amu.1.1.11
Adrenaline Use During Adult Cardiopulmonary Resuscitation: A Double-Edged Sword?
Ingrid Bošan-Kilibarda
; Croatian Society of Emergency Medicine, Zagreb, Croatia
*
Višnja Nesek Adam
; University Hospital Sveti Duh, Zagreb, Croatia
* Corresponding author.
Abstract
For many years, adrenaline has been a key component of advanced life support guidelines for patients experiencing cardiac arrest. Despite its prolonged use during cardiopulmonary resuscitation (CPR), its efficacy and safety remain subjects of debate. Adrenaline increases the chances of return of spontaneous circulation and survival to hospital admission and discharge, but its effects on long-term survival and neurological outcomes are ambiguous. Over time, clinicians and researchers have questioned the optimal dose of adrenaline, as the standard adult dose of 1 mg per administration is not adjusted for body weight. Historically, this dose was used for intracardiac injections in surgical settings. Further studies have indicated that higher doses of adrenaline do not lead to better outcomes and may even be potentially harmful. The optimal timing and interval for administering adrenaline during CPR remain unclear, though some studies suggest that early administration and shorter intervals between doses may improve ROSC and survival rates, although these factors may not result in significantly better neurological outcomes. This article provides a brief overview of the literature and research results concerning key issues related to the use of adrenaline during CPR. The variability of results strongly supports the need for multicenter, prospective randomized studies to determine the optimal dose, the total number of doses beyond which no further benefit is gained, and the ideal timing and intervals between doses. Additionally, alternatives to current protocols should be explored. Future research should focus on long-term outcomes that extend beyond ROSC in order to achieve better functional outcomes for patients with cardiac arrest.
Keywords
Adrenaline; Cardiopulmonary Resuscitation, Adult; Controversies
Hrčak ID:
333869
URI
Publication date:
1.2.2025.
Visits: 262 *