Potential complications of high-dose epinephrine therapy in patients resuscitated from cardiac arrest

JAMA. 1991 Mar 6;265(9):1117-22.

Abstract

Adults resuscitated from nontraumatic cardiac arrest who received intravenous epinephrine in doses chosen by the treating physician and who survived at least 6 hours were studied to determine if high-dose epinephrine produced more complications than standard-dose. A total of 68 patients were enrolled and evaluated for postresuscitation complications attributable to epinephrine, using a two-tailed t test, and contingency analysis. The 33 patients receiving high-dose epinephrine and 35 patients receiving standard-dose epinephrine were similar in demographics and variables known to affect outcome. There was no difference in potential complications between groups except serum calcium, which was 1.97 mmol/L (SD, 0.20) in the high-dose epinephrine group and 2.10 (SD, 0.20) in the standard-dose group. Hospital discharge rates (18% in the high-dose vs 30% in the standard-dose group) and neurological status on discharge were not significantly different. High-dose epinephrine did not produce increased direct complications in this cardiac arrest population compared with standard-dose epinephrine.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Calcium / blood
  • Electrocardiography
  • Epinephrine / administration & dosage*
  • Epinephrine / adverse effects
  • Female
  • Heart Arrest / drug therapy
  • Heart Arrest / mortality
  • Heart Arrest / therapy*
  • Humans
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care / statistics & numerical data
  • Prospective Studies
  • Regression Analysis
  • Resuscitation*

Substances

  • Calcium
  • Epinephrine