Effect of epinephrine administration on return of spontaneous circulation in cardiopulmonary arrest patients randomized prospective clinical trial

OBJECTIVE: To identify effect of epinephrine on return of spontaneous circulation (ROSC) in cardiopulmonary resuscitation METHODS: The study was performed between August 1, 2016 and May 31, 2017. Patients (≥ 18 years old) in arrest who presented to Gaziantep University Department of Emergency Medicine and three State Hospitals in Gaziantep Province were included. Patients were divided into two groups as epinephrine group (Group 1) and non-epinephrine group (Group 2). ROSC and one month mortality were investigated. SPSS 22.0 was used for statistical analysis. RESULTS: 150 patients were enrolled. The mean age of patients was 64, 2 (±16, 9). 78 (52%) of the patients were male and 72 (48%) were female. Rates of witnessed and unwitnessed arrest were 77, 3% and 22, 7%, respectively. Rates of in-hospital and out-of-hospital arrest patients were 27, 3% and 72, 7%. 77 (51, 3%) patients were in Group 1, 73 (48, 7%) patients were in Group 2. The number of arrest due to trauma, cardiac causes and non-cardiac causes were 12 (8%), 81 (54%) and 57 (38%), respectively. Median time to chest compression initiation after recognition of cardiac arrest was 6.9 (±5, 5) minutes. 34 (22, 7%) of patients attained ROSC. Mean time of the first attained ROSC was 32, 8 min. The rate of initial detected rhythms were: % 11,3 (n: 17) VF, % 3,3 (n: 5) pulseless VT, %11,3 (17) NEA and %70 (105) asystole. 40 (26, 7%) patients underwent defibrillation. Median time to administration of the first dose of epinephrine after arrest was 15, 36 ±10, 32 min. The average dose of epinephrine was 6, 3 ± 6, 3 mg. The mean time from 112 (Emergency Medical Service) call to 112 team departure, from departure to scene arrival, from scene to hospital arrival were 2,2 (±1), 5.5 (±2.8),15,9 (±8,5) min, respectively. Arterial blood gases taken within 5 minutes of hospital arrival showed pH 7.04 (±0.17), Lactate 11, 4 (± 4, 9) mmol/L, PCO2 58, 1 (± 19, 01) mmHg. Only three arrest patients had bystander chest compressions. The mortality rate of one month was 85, 2% (n: 29). CONCLUSION: In our study, there was no significant relationship between epinephrine and either ROSC or one month mortality. KEYWORDS: Epinephrine, Cardiopulmonary Resuscitation, Arrest, Return of Spon-taneous circulation