Original Article
A Comparison of Standard-Dose and High-Dose Epinephrine in Cardiac Arrest outside the Hospital
N Engl J Med 1992; 327:1051-1055October 8, 1992
- Abstract
- Abstract
Background.
Experimental and uncontrolled clinical evidence suggests that intravenous epinephrine in doses higher than currently recommended may improve outcome after cardiac arrest. We conducted a prospective, multicenter study comparing standard-dose epinephrine with high-dose epinephrine in the management of cardiac arrest outside the hospital.
Methods.
Adult patients were enrolled in the study if they remained in ventricular fibrillation, or if they had asystole or electromechanical dissociation, at the time the first drug was to be administered to treat the cardiac arrest. Patients were randomly assigned to receive either 0.02 mg of epinephrine per kilogram of body weight (standard-dose group, 632 patients) or 0.2 mg per kilogram (high-dose group, 648 patients), both given intravenously.
Results.
In the standard-dose group 190 patients (30 percent) had a return of spontaneous circulation, as compared with 217 patients (33 percent) in the high-dose group; 136 patients (22 percent) in the standard-dose group and 145 patients (22 percent) in the high-dose group survived to be admitted to the hospital. Twenty-six patients (4 percent) in the standard-dose group and 31 (5 percent) in the high-dose group survived to discharge from the hospital. Ninety-two percent of the patients discharged in the standard-dose group and 94 percent in the high-dose group were conscious at the time of hospital discharge. None of the differences in outcome between the groups were statistically significant.
Conclusions.
In this study, we were unable to demonstrate any difference in the overall rate of return of spontaneous circulation, survival to hospital admission, survival to hospital discharge, or neurologic outcome between patients treated with a standard dose of epinephrine and those treated with a high dose. (N Engl J Med 1992;327: 1051–5.)
Media in This Article
Table 1
Characteristics of the Patients and EMS Systems.*Table 2
Primary Outcome Measures.Article Activity
- Article
RECENT experimental studies of cardiac arrest have demonstrated that, as compared with standard doses of epinephrine (0.01 to 0.02 mg per kilogram of body weight), a larger dose (0.2 mg per kilogram) improves cerebral and myocardial blood flow, the balance between myocardial oxygen supply and demand, and rates of resuscitation.1 2 3 4 5 6 7 As a result of these investigations, larger doses of epinephrine have been evaluated in several uncontrolled clinical trials.8 9 10 11 12 These studies have found improvement in arterial diastolic pressure,8 coronary perfusion pressure,9 rates of resuscitation,10 and neurologic outcome11 , 12 with high doses of epinephrine.
To compare the efficacy of high-dose epinephrine (0.2 mg per kilogram) with that of the standard dose (0.02 mg per kilogram) in improving the outcome of resuscitation after out-of-hospital cardiac arrest, we conducted a prospective, randomized, multicenter, double-blind study.
Methods
The study protocol was approved by the institutional review board at each of the six participating study centers. Waiver of informed consent was accepted under the guidelines specified in regulation 50.23 of the Food and Drug Administration.
Patients
Patients for this study were selected from the populations served by the Emergency Medical Services (EMS) systems of Columbus, Ohio; Houston, Texas; King County, Washington; Milwaukee, Wisconsin; Richmond, Virginia; and Syracuse, New York. The study was conducted from October 1, 1989, through December 1, 1990. Patients more than 18 years of age who had cardiopulmonary arrest outside the hospital were eligible for inclusion in the study. A cardiopulmonary arrest was defined as the absence of both spontaneous respiration and palpable pulse. Patients with cardiopulmonary arrest were included in the study if the initial electrocardiographic (ECG) tracing indicated ventricular fibrillation and the patient remained in ventricular fibrillation despite three successive countershocks; if the initial ECG tracing indicated ventricular fibrillation and the ECG rhythm changed to asystole or electromechanical dissociation (defined as any organized ECG complex in the absence of a palpable pulse) after the initial countershocks; or if after basic cardiopulmonary resuscitation (CPR), endotracheal intubation, and the establishment of intravenous access, the initial ECG tracing indicated either asystole or electromechanical dissociation.
Patients who were pregnant or whose cardiopulmonary arrest was associated with trauma, hypothermia, drowning, drug overdose (confirmed by toxicologic analysis), or a primary respiratory arrest (due to upper airway obstruction or hanging, for example) were excluded from the study. Patients were also excluded if an endotracheal tube or intravenous line could not be placed, or if they had clear signs of irreversible cardiac arrest (such as rigor mortis, decomposition, or dependent lividity).
Assignment to Treatment
Patients were assigned to receive either the standard dose of epinephrine (standard-dose group) or a higher dose of epinephrine (high-dose group) by means of numbered and coded syringes that had previously been placed in random order within packaged groups and then randomly distributed by the manufacturer (Abbott Laboratories, Abbott Park, Ill.) to each study center.
Treatment
Patients in the two groups were treated according to standard American Heart Association guidelines,13 except that the first dose of epinephrine was 0.02 mg per kilogram in the standard-dose group and 0.2 mg per kilogram in the high-dose group. To blind the paramedics to the initial dose of epinephrine, precoded, prefilled 20-ml syringes that were identical in appearance were used. The body weights of patients were estimated in pounds, and the dose of epinephrine was administered accordingly, with syringes marked in 10-pound increments (range, 60 to 220). The epinephrine concentration in the syringes used for the standard-dose group was 1:10,000, whereas that in the syringes for the high-dose group was 1:1000. Thus, regardless of the study group, equal volumes were administered to patients with the same estimated body weight. The intravenous administration of epinephrine was followed by flushing of the intravenous line with 20 ml of normal saline.14 Epinephrine (both standard-dose and high-dose therapy) and all normal saline flushes were given by peripheral intravenous injection. Subsequent therapy followed American Heart Association guidelines.13 During the course of the trial all personnel providing care outside the hospital and all study-center investigators remained blinded as to which dose was administered.
Outcome Measures
The following primary measures of outcome were assessed: return of spontaneous circulation, defined as the return of a palpable pulse and blood pressure (palpable, auditory, or both), without ongoing cardiopulmonary resuscitation, for at least one minute at any time after the administration of the first dose of epinephrine; successful resuscitation, defined as the admission of a patient to the emergency department with a palpable pulse and blood pressure after the return of spontaneous circulation; admission to the hospital, defined as the admission of a patient as an inpatient with a palpable pulse and blood pressure; and discharge from the hospital alive. We also assessed whether patients were conscious at the time of hospital discharge, using a system for grading cerebral performance.15 , 16 The cerebral-performance categories we used were as follows: category 1, conscious and alert with normal function or only slight disability; category 2, conscious and alert with moderate disability; category 3, conscious with severe disability; category 4, comatose or in a persistent vegetative state; and category 5, brain-dead. Each patient's cerebral-performance category at the time of hospital discharge was determined either retrospectively from hospital records or by physical examination.
Specific characteristics of the EMS systems were measured, including the "response interval" and "CPR interval." The response interval was defined as the time from the first telephone call reporting the emergency to the arrival of paramedics at the scene of the cardiac arrest. The CPR interval was defined as the time from the initiation of basic CPR to the initial return of spontaneous circulation. In the case of patients whose cardiopulmonary arrest was witnessed by a bystander, an emergency medical technician, or a paramedic, the "arrest interval" and "epinephrine interval" were also measured. The arrest interval was defined as the time from the onset of cardiopulmonary arrest to the initiation of basic CPR, and the epinephrine interval as the time from the onset of the cardiopulmonary arrest to the administration of epinephrine from the study syringe.
Several prospectively defined variables were recorded immediately after the return of spontaneous circulation; these included hypotension (systolic blood pressure, <90 mm Hg), hypertension (systolic blood pressure, ≥200 mm Hg, or diastolic blood pressure, ≥120 mm Hg), frequent premature ventricular contractions (more than six per minute), multifocal premature ventricular contractions, and the recurrence of cardiac arrest.
Statistical Analysis
Means and standard deviations were determined for continuous variables. Percentages were determined for dichotomous variables. Ninety-nine percent confidence intervals were calculated for the differences in the primary outcome measures between the standard-dose group and the high-dose group. Ninety-five percent confidence intervals were calculated for the differences between the groups for all other outcome measures. Cerebral performance at hospital discharge was compared by combining patients who were conscious (categories 1, 2, and 3) and combining those who were unconscious (categories 4 and 5). Categorical variables with more than two outcome measures were compared by chi-square analysis or Fisher's exact test. All comparisons were two-tailed. For the primary outcome measure, the results were considered to be statistically significant if the P value was ≤0.01 (with Bonferroni's adjustment)17 or if the 99 percent confidence interval did not include zero. For all other outcome measures, the results were considered to be statistically significant when the 95 percent confidence interval did not include zero. Subgroup analyses were performed to assess the rates of return of spontaneous circulation, hospital admission, and discharge; the subgroups were stratified according to both the epinephrine interval and the presenting ECG rhythm.
Complications after resuscitation, mortality, and neurologic outcome in the standard-dose and high-dose groups were assessed by a risk-monitoring committee that did not include any of the investigators. The findings of this committee were presented to the institutional review board at Ohio State University College of Medicine and were used to determine whether the risks to the patients in the study remained within acceptable limits.
Results
Characteristics of the Patients and EMS Systems
The study population for this investigation was 1280 patients, with 632 randomly assigned to the standard-dose group and 648 to the high-dose group. The characteristics of the patients and the EMS systems were well matched in the two groups (Table 1Table 1
Characteristics of the Patients and EMS Systems.*). The numbers of patients in Tables 1, 2Table 2Primary Outcome Measures., and 3Table 3
Outcome Measures in Patients with Return of Spontaneous Circulation.* do not always equal the total number enrolled because certain data were unavailable for some patients.Outcome Measures
The rates of return of spontaneous circulation, successful resuscitation, hospital admission, and survival to hospital discharge were similar between the two groups (Table 2). Ninety-two percent of the patients in the standard-dose group and 94 percent in the high-dose group who survived to hospital discharge were conscious at the time of discharge (Table 2).
The average pulse rate at the time of the return of spontaneous circulation was 109 per minute in the standard-dose group and 115 per minute in the high-dose group (95 percent confidence interval for the difference, -14 to 1). Sixty of the 190 patients in the standard-dose group who had a return of spontaneous circulation (32 percent) and 40 of the 217 in the high-dose group (18 percent) were categorized as having hypotension when spontaneous circulation returned (95 percent confidence interval for the difference, 5 to 22 percent). Systolic hypertension was observed at the time of the return of spontaneous circulation in 12 patients (6 percent) in the standard-dose group and in 32 patients (15 percent) in the high-dose group (95 percent confidence interval for the difference, -14 to -3 percent). Diastolic hypertension was observed almost twice as often in the high-dose group (10 percent) as in the standard-dose group (6 percent) (95 percent confidence interval for the difference, -10 to 1 percent).
The high-dose group had a higher percentage of patients with frequent premature ventricular contractions (>6 per minute), although the percentages of patients with multifocal premature ventricular contractions were similar in the two groups. The percentages of patients in whom cardiac arrest recurred after the return of spontaneous circulation were also similar (Table 3).
The percentages of patients admitted to the hospital who died before discharge (in-hospital mortality) were similar in the two groups (P = 0.98). In the first 72 hours, the mortality rate was 42 percent in the standard-dose group and 43 percent in the high-dose group. From 72 to 96 hours after the return of spontaneous circulation, the in-hospital mortality rate was 17 percent in both groups; after 96 hours, it was 41 percent in the standard-dose group and 40 percent in the high-dose group.
Subgroup analyses produced several interesting findings. When high-dose epinephrine was administered within 10 minutes after the onset of cardiac arrest, the rates of survival to hospital discharge were 23 percent in the high-dose group and 11 percent in the standard-dose group (95 percent confidence interval for the difference, -28 to 3 percent). When the groups were stratified according to the presenting ECG rhythm, patients with electromechanical dissociation had higher rates of return of spontaneous circulation when treated with high-dose epinephrine (47 percent) than when they received standard-dose epinephrine (33 percent; 95 percent confidence interval for the difference, -26 to -2 percent).
Discussion
Our results indicate that in patients who have cardiac arrest outside the hospital, the rates of return of spontaneous circulation, successful resuscitation, hospital admission, and hospital discharge and measures of neurologic outcome were similar after treatment with either standard-dose or high-dose epinephrine. One potential explanation for the discrepancy between the results of experimental studies and those of this clinical trial is that in our study more than 60 percent of the cardiac arrests were not witnessed. Presumably, for most of the patients with unwitnessed arrests, the time from onset to the receipt of epinephrine was prolonged; this length of time may have precluded successful resuscitation. Even for patients whose cardiac arrests were witnessed, the time to the receipt of epinephrine averaged 17 minutes in our study, whereas in the experimental models used to predict clinical dose requirements, this interval was 13 minutes.1 , 3 4 5 6 7 Although some improvement in cerebral and myocardial oxygen delivery may have occurred, the level and duration of oxygen delivery required for successful resuscitation may be greater in humans than in laboratory animals — particularly when ischemia is prolonged. In this study, on the other hand, when epinephrine was administered within 10 minutes of the onset of cardiac arrest, there was a trend toward improved rates of survival to hospital discharge in the high-dose group. Therefore, there may be subgroups of patients who would benefit from higher doses of epinephrine, although further study is needed to evaluate this hypothesis.
In addition, the discrepancy between laboratory studies and the results of this clinical trial could be explained by the fact that the majority of patients who die suddenly from cardiac causes have fixed atherosclerotic coronary artery disease.18 In such patients, any improvement in myocardial oxygen delivery due to higher doses of epinephrine may be offset by a concomitant increase in myocardial oxygen consumption resulting from the beta1-adrenergic effects of epinephrine.19 , 20 In patients with electromechanical dissociation, however, the rate of return of spontaneous circulation was higher when patients were treated with high-dose epinephrine than when they received standard-dose epinephrine. As compared with patients with atherosclerotic coronary disease, in whom ventricular fibrillation is the most common presenting ECG rhythm in cardiac arrest, patients whose presenting ECG rhythm is electromechanical dissociation probably have a lower incidence of coronary artery disease. Therefore, there may be a net metabolic benefit to the myocardium when patients with electromechanical dissociation are treated with high-dose epinephrine rather than with standard-dose therapy. Improved rates of resuscitation in this subgroup of patients have been reported previously.21
This study has some limitations. For the majority of patients, we assessed neurologic outcome according to the system of cerebral-performance categories by review of patients' charts. Subtle differences in neurologic outcome may be difficult to detect using this retrospective approach. For this reason, we combined cerebral-performance categories 1 through 3 to identify a subgroup of patients who were conscious at hospital discharge, and categories 4 and 5 to identify a subgroup of patients who were unconscious at discharge. We believe that this information on neurologic status can be obtained accurately without directly examining the patient. For patients who regained consciousness after cardiac arrest, it would have been helpful to assess their degree of independence in activities of daily living. Although obtaining such data would have required more extensive assessment of the patients, it would have made it possible to discern important differences in neurologic outcome after cardiac arrest. Another limitation is that other variables that might have affected neurologic outcome, such as particular therapies given in the hospital, could not be controlled for in this study. Because the number of patients in the two treatment groups who were admitted as inpatients was small, we could not be sure that these confounding variables were equally distributed between the two groups. Furthermore, we did not obtain long-term follow-up data on patients discharged from the hospital. Therefore, neurologic recovery may not have been precisely measured.
In addition, because the rate of survival among patients given standard-dose epinephrine is already quite low, a Type II error is likely. This problem underscores the need to study larger groups of patients in future trials, particularly if subgroups of survivors are to be compared. Finally, although we tried to exclude patients with primary respiratory arrest and those in whom cardiac arrest resulted from a drug overdose, it was difficult to identify such patients accurately even after retrospective review of all available information. We therefore performed an intention-to-treat analysis that included all patients treated with epinephrine at either dose. The results of this analysis did not change our conclusions regarding any of the primary outcome measures.
Although we could not demonstrate any benefit from high-dose epinephrine in this study, we found no adverse effects. One important concern about the use of high doses of epinephrine is the possibility that patients who have already sustained irreversible neurologic injury will be resuscitated. In our study there was no such effect. Another possible complication of high-dose epinephrine is ventricular dysrhythmias occurring after the return of spontaneous circulation. Despite a significantly higher percentage of patients with frequent premature ventricular contractions in the high-dose group, we did not find that a higher percentage of patients in this group had recurrence of cardiac arrest.
In this study, we were unable to demonstrate any difference in the overall rate of return of spontaneous circulation, survival to hospital admission, survival to hospital discharge, or neurologic outcome between patients who received 0.2 mg of epinephrine per kilogram and those who received 0.02 mg per kilogram as the first pharmacologic treatment for out-of-hospital cardiac arrest associated with ventricular fibrillation, asystole, or electromechanical dissociation.
*The members of the Multicenter High-Dose Epinephrine Study Group are listed in the Appendix.
We are indebted to the emergency medical technicians and paramedics serving Columbus, Ohio; Houston, Texas; King County, Washington; Milwaukee, Wisconsin; Richmond, Virginia; and Syracuse, New York; whose dedication and diligence made this study possible; to Lynn Mitchell, M.S., and Melvin Moeschberger, Ph.D., who performed the data analysis and monitored the ongoing results of the trial; and to Abbott Laboratories, which manufactured and supplied the syringes and epinephrine used in this study.
Source Information
From the Department of Emergency Medicine, Ohio State University, Columbus (C.G.B., D.R.M.); the City of Houston Emergency Medical Services and the Departments of Medicine, Surgery, and Pediatrics, Baylor College of Medicine, Houston (P.E.P.); the Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee (H.S.); the Emergency Medicine Services, University of Washington, Seattle (R.O.C.); the Section of Emergency Medical Services, Medical College of Virginia, Richmond (E.G.); and the Program in Multidisciplinary Critical Care, State University of New York Health Sciences Center at Syracuse (M.J.). Address reprint requests to Dr. Brown at the Department of Emergency Medicine, Ohio State University, 108 Means Hall, 1654 Upham Dr., Columbus, OH 43210.
Appendix
The members of the Multicenter High-Dose Epinephrine Study Group are as follows: D. Keseg, Department of Emergency Medicine, Riverside Hospital, Columbus, Ohio; R.F. Griffith, Department of Emergency Medicine, Ohio State University, Columbus; F. Birinyi, Department of Emergency Medicine, Mount Carmel Medical Center, Columbus; L. Elliot, Department of Emergency Medicine, St. Anthony's Medical Center, Columbus; M. Blue, Department of Emergency Medicine, St. Ann's Hospital, Columbus; R. Thomas and S. Melmed, Department of Emergency Medicine, Grant Hospital, Columbus; L. Bowman, Department of Emergency Medicine, St. Anthony—Mercy Hospital, Columbus; P. Bell, Department of Emergency Medicine, Doctors North Hospital, Columbus; E. Waite, Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee; A. Milewski, Program in Multidisciplinary Critical Care, State University of New York Health Sciences Center at Syracuse; V. Ginger and J. Groom, City of Houston Emergency Medical Services, Houston; J. Graves, Emergency Medicine Services, University of Washington, Seattle; and J.P. Ornato, Division of Cardiology, and E.M. Racht, Section of Emergency Medical Services, Department of Internal Medicine, Medical College of Virginia, Richmond.
- References
References
1
Brown
CrossRef | Web of Science | Medline2
Kosnik
CrossRef | Web of Science | Medline3
Brown
CrossRef | Web of Science | Medline4
Brown
CrossRef | Web of Science | Medline5
Brown
CrossRef | Web of Science | Medline6
Brown
CrossRef | Web of Science | Medline7
Brown
CrossRef | Web of Science | Medline8
Gonzalez
CrossRef | Web of Science | Medline9
Paradis
CrossRef | Web of Science | Medline10
Barton 11
Koscove
CrossRef | Web of Science | Medline12
Goetting
Web of Science | Medline13
Standards and guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC) . JAMA 1986;255:2905–84.
CrossRef | Web of Science14
Emerman
CrossRef | Web of Science | Medline15
Brain Resuscitation Clinical Trial I Study Group
Full Text | Web of Science | Medline16
Safar
CrossRef17
Neter J, Wasserman W, Kutner MH. Applied linear statistical models: repression, analysis of variance, and experimental designs. 2nd ed. Homewood, Ill.: Richard D. Irwing, 1985.
18
Kuller
CrossRef | Web of Science | Medline19
Livesay
Web of Science | Medline20
Ditchey
CrossRef | Web of Science | Medline21
Lindner
CrossRef | Web of Science | Medline
- Citing Articles (126)
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CrossRef12
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CrossRef13
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CrossRef14
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CrossRef15
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CrossRef16
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CrossRef21
M. Baubin, B. Dirks, M. Holzer, V. Wenzel. (2009) ILCOR hot topics. Notfall + Rettungsmedizin 12:S2, 28-33
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Alan Jay Schwartz. (2009) PALS Update, 2009. ASA Refresher Courses in Anesthesiology 37:1, 175-187
CrossRef23
Iyad M. Ayoub, Jeejabai Radhakrishnan, Raúl J. Gazmuri. (2008) Targeting mitochondria for resuscitation from cardiac arrest. Critical Care Medicine 36:Suppl, S440-S446
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Full Text27
Marc D. Berg, Vinay M. Nadkarni, Mathias Zuercher, Robert A. Berg. (2008) In-Hospital Pediatric Cardiac Arrest. Pediatric Clinics of North America 55:3, 589-604
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CrossRef38
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(2006) Adult advanced life support: Australian Resuscitation Council Guidelines 2006. Emergency Medicine Australasia 18:4, 337-356
CrossRef40
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CrossRef41
Todd A Miano, Michael A Crouch. (2006) Evolving Role of Vasopressin in the Treatment of Cardiac Arrest. Pharmacotherapy 26:6, 828-839
CrossRef42
Fabian Sp??hr, Volker Wenzel, Bernd W. B??ttiger. (2006) Drug treatment and thrombolytics during cardiopulmonary resuscitation. Current Opinion in Anaesthesiology 19:2, 157-165
CrossRef43
Ricardo A. Samson, Marc D. Berg, Robert A. Berg. (2006) Cardiopulmonary resuscitation algorithms, defibrillation and optimized ventilation during resuscitation. Current Opinion in Anaesthesiology 19:2, 146-156
CrossRef44
Joseph P. Ornato, Mary Ann Peberdy. (2006) Prehospital and Emergency Department Care to Preserve Neurologic Function During and Following Cardiopulmonary Resuscitation. Neurologic Clinics 24:1, 23-39
CrossRef45
R. Blaine Easley, Charles L. Schleien, Donald H. Shaffner. 2006. , 1110.
CrossRef46
Iyad M. Ayoub, Julieta Kolarova, Ronald L. Kantola, Robert Sanders, Ra??l J. Gazmuri. (2005) Cariporide minimizes adverse myocardial effects of epinephrine during resuscitation from ventricular fibrillation*. Critical Care Medicine 33:11, 2599-2605
CrossRef47
Katherine M. Hiller, Jason S. Haukoos, Kennon Heard, Jonathan S. Tashkin, Norman A. Paradis. (2005) Impact of the Final Rule on the Rate of Clinical Cardiac Arrest Research in the United States. Academic Emergency Medicine 12:11, 1091-1098
CrossRef48
Henry E. Wang, Alice Min, David Hostler, Chung-Chou H. Chang, Clifton W. Callaway. (2005) Differential effects of out-of-hospital interventions on short- and long-term survival after cardiopulmonary arrest. Resuscitation 67:1, 69-74
CrossRef49
Mahesh Sharman, Kathleen L. Meert. (2005) What is the right dose of epinephrine?. Pediatric Critical Care Medicine 6:5, 592-594
CrossRef50
Mary Ann Peberdy, Joseph P. Ornato. (2005) Post-resuscitation care: is it the missing link in the Chain of Survival?. Resuscitation 64:2, 135-137
CrossRef51
Francis X. Guyette, Guy E. Guimond, David Hostler, Clifton W. Callaway. (2004) Vasopressin administered with epinephrine is associated with a return of a pulse in out-of-hospital cardiac arrest. Resuscitation 63:3, 277-282
CrossRef52
G Nichol, E Huszti, J Rokosh, A Dumbrell, J McGowan, L Becker. (2004) Impact of informed consent requirements on cardiac arrest research in the United States: exception from consent or from research?. Resuscitation 62:1, 3-23
CrossRef53
Robert A Berg, Fred W Chapman, Marc D Berg, Ronald W Hilwig, Isabelle Banville, Robert G Walker, Richard C Nova, Duane Sherrill, Karl B Kern. (2004) Attenuated adult biphasic shocks compared with weight-based monophasic shocks in a swine model of prolonged pediatric ventricular fibrillation. Resuscitation 61:2, 189-197
CrossRef54
Perondi, Maria Beatriz M., Reis, Amelia G., Paiva, Edison F., Nadkarni, Vinay M., Berg, Robert A., . (2004) A Comparison of High-Dose and Standard-Dose Epinephrine in Children with Cardiac Arrest. New England Journal of Medicine 350:17, 1722-1730
Full Text55
Wanchun Tang, Max Harry Weil, Shijie Sun, Dawn Jorgenson, Carl Morgan, Kada Klouche, David Snyder. (2004) The effects of biphasic waveform design on post-resuscitation myocardial function. Journal of the American College of Cardiology 43:7, 1228-1235
CrossRef56
Jinglan Wang, Max Harry Weil, Takashi Kamohara, Wanchun Tang, Shijie Sun, Kada Klouche, Joe Bisera. (2004) A lazaroid mitigates postresuscitation myocardial dysfunction. Critical Care Medicine 32:2, 553-558
CrossRef57
M MORRIS, V NADKARNI. (2003) Pediatric cardiopulmonary-cerebral resuscitation: an overview and future directions. Critical Care Clinics 19:3, 337-364
CrossRef58
Robert E. O'Connor, Joseph P. Ornato, Jane Wigginton, Richard C. Hunt, Gregory Mears, Joe Penner. (2003) A LTERNATIVE C ARDIOPULMONARY R ESUSCITATION D EVICES. Prehospital Emergency Care 7:1, 31-41
CrossRef59
Gad Bar-Joseph, Norman S Abramson, Linda Jansen-McWilliams, Sheryl F Kelsey, Tatiania Mashiach, Mary T Craig, Peter Safar. (2002) Clinical use of sodium bicarbonate during cardiopulmonary resuscitation—is it used sensibly?. Resuscitation 54:1, 47-55
CrossRef60
Mikael Holmberg, Stig Holmberg, Johan Herlitz. (2002) Low chance of survival among patients requiring adrenaline (epinephrine) or intubation after out-of-hospital cardiac arrest in Sweden. Resuscitation 54:1, 37-45
CrossRef61
S. HACHIMI-IDRISSI, L. HUYGHENS. (2002) Advanced cardiac life support update: the new ILCOR cardiovascular resuscitation guidelines. European Journal of Emergency Medicine 9:2, 193-202
CrossRef62
Samuel J. Stratton, James T. Niemann. (2002) Reconsideration of proximate Utstein-style end points. Critical Care Medicine 30:Supplement, S137-S139
CrossRef63
Jacobo Wortsman. (2002) Role of epinephrine in acute stress. Endocrinology & Metabolism Clinics of North America 31:1, 79-106
CrossRef64
Michael R. Sayre, Marianne Gausche-Hill. (2002) Conducting Randomized Trials in the Prehospital Setting. Prehospital Emergency Care 6:s2, S38-S47
CrossRef65
(2002) The National EMS Research Agenda Writing Team. Prehospital Emergency Care 6:s3, 1-43
CrossRef66
James T. Niemann, Samuel J Stratton. (2001) The Utstein template and the effect of in-hospital decisions: the impact of do-not-attempt resuscitation status on survival to discharge statistics. Resuscitation 51:3, 233-237
CrossRef67
Mark G. Angelos, James J. Menegazzi, Clifton W. Callaway. (2001) Bench to Bedside Resuscitation from Prolonged Ventricular Fibrillation. Academic Emergency Medicine 8:9, 909-924
CrossRef68
Rolf Gedeborg, Hans C:son Silander, Sten Rubertsson, Lars Wiklund. (2001) Cerebral ischaemia in experimental cardiopulmonary resuscitation — comparison of epinephrine and aortic occlusion. Resuscitation 50:3, 319-329
CrossRef69
Wolfgang G. Voelckel, Keith G. Lurie, Scott McKnite, Todd Zielinski, Paul Lindstrom, Colleen Peterson, Volker Wenzel, Karl H. Lindner. (2001) Comparison of epinephrine with vasopressin on bone marrow blood flow in an animal model of hypovolemic shock and subsequent cardiac arrest. Critical Care Medicine 29:8, 1587-1592
CrossRef70
Ian G Stiell, Paul C Hébert, George A Wells, Katherine L Vandemheen, Anthony SL Tang, Lyall AJ Higginson, Jonathan F Dreyer, Catherine Clement, Erica Battram, Irene Watpool, Sharon Mason, Terry Klassen, Brian N Weitzman. (2001) Vasopressin versus epinephrine for inhospital cardiac arrest: a randomised controlled trial. The Lancet 358:9276, 105-109
CrossRef71
Timothy Kelsch, Kerry Kikuchi, Shadi Vahdat, William H. Frishman. (2001) Innovative Pharmacologic Approaches to Cardiopulmonary Resuscitation. Heart Disease46-54
CrossRef72
Armand R.J. Girbes. (2000) Rational use of vasoactive drugs after cardiac resuscitation: focus on inotropic agents. Resuscitation 47:3, 339-342
CrossRef73
Carl L. Gwinnutt, Malachy Columb, Robert Harris. (2000) Outcome after cardiac arrest in adults in UK hospitals: effect of the 1997 guidelines. Resuscitation 47:2, 125-135
CrossRef74
Timothy J. Mader, Barry Bertolet, Joseph P. Ornato, Jeffrey M. Gutterman. (2000) Aminophylline in the treatment of atropine-resistant bradyasystole. Resuscitation 47:2, 105-112
CrossRef75
Ronald W. Hilwig, Karl B. Kern, Robert A. Berg, Arthur B. Sanders, Charles W. Otto, Gordon A. Ewy. (2000) Catecholamines in cardiac arrest: role of alpha agonists, beta-adrenergic blockers and high-dose epinephrine. Resuscitation 47:2, 203-208
CrossRef76
J MANNING, L KATZ. (2000) CARDIOPULMONARY AND CEREBRAL RESUSCITATION. Critical Care Clinics 16:4, 659-679
CrossRef77
Wolfgang G. Voelckel, Keith G. Lurie, Karl H. Lindner, Todd Zielinski, Scott McKnite, Anette C. Krismer, Volker Wenzel. (2000) Vasopressin Improves Survival After Cardiac Arrest in Hypovolemic Shock. Anesthesia & Analgesia627-634
CrossRef78
Ken Nagao, Nariyuki Hayashi, Katsuo Kanmatsuse, Ken Arima, Jyoji Ohtsuki, Kimio Kikushima, Ikuyoshi Watanabe. (2000) Cardiopulmonary cerebral resuscitation using emergency cardiopulmonary bypass, coronary reperfusion therapy and mild hypothermia in patients with cardiac arrest outside the hospital. Journal of the American College of Cardiology 36:3, 776-783
CrossRef79
Wolfgang G. Voelckel, Keith G. Lurie, Karl H. Lindner, Todd Zielinski, Scott McKnite, Anette C. Krismer, Volker Wenzel. (2000) Vasopressin Improves Survival After Cardiac Arrest in Hypovolemic Shock. Anesthesia & Analgesia 91:3, 627-634
CrossRef80
C. Vandycke, P. Martens. (2000) High dose versus standard dose epinephrine in cardiac arrest — a meta-analysis. Resuscitation 45:3, 161-166
CrossRef81
(2000) Part 6: Advanced Cardiovascular Life Support. Resuscitation 46:1-3, 155-162
CrossRef82
Daniel DeBehnke. (2000) The Effects of Graded Doses of Endothelin-1 on Coronary Perfusion Pressure and Vital Organ Blood Flow during Cardiac Arrest. Academic Emergency Medicine 7:3, 211-221
CrossRef83
Gordon A Ewy, Joseph P Ornato. (2000) Emergency cardiac care: introduction. Journal of the American College of Cardiology 35:4, 825-880
CrossRef84
Volker Wenzel, Karl H. Lindner, Anette C. Krismer, Wolfgang G. Voelckel, Michael F. Schocke, Wolfgang Hund, Markus Witkiewicz, Egfried A. Miller, Günter Klima, Jörg Wissel, Werner Lingnau, Franz T. Aichner. (2000) Survival with full neurologic recovery and no cerebral pathology after prolonged cardiopulmonary resuscitation with vasopressin in pigs. Journal of the American College of Cardiology 35:2, 527-533
CrossRef85
James J. Menegazzi, David C. Seaberg, Donald M. Yealy, Eric A. Davis, Bruce A. MacLeod. (2000) C OMBINATION P HARMACOTHERAPY WITH D ELAYED C OUNTERSHOCK VS S TANDARD A DVANCED C ARDIAC L IFE S UPPORT A FTER P ROLONGED V ENTRICULAR F IBRILLATION. Prehospital Emergency Care 4:1, 31-37
CrossRef86
Gad Bar-Joseph, Tuvia Weinberger, Shlomo Ben-Haim. (2000) Response to repeated equal doses of epinephrine during cardiopulmonary resuscitation in dogs. Annals of Emergency Medicine 35:1, 3-10
CrossRef87
Wanchun Tang, Max Harry Weil, Shijie Sun, Hitoshi Yamaguchi, Heitor P Povoas, Andreja Marn Pernat, Joe Bisera. (1999) The effects of biphasic and conventional monophasic defibrillation on postresuscitation myocardial function. Journal of the American College of Cardiology 34:3, 815-822
CrossRef88
Berend Mets, Margaret Wood. (1999) Arginine vasopressin: old drug, new uses. Current Opinion in Anaesthesiology 12:4, 433-436
CrossRef89
Sardar Ijlal Babar, Robert A. Berg, Ronald W. Hilwig, Karl B. Kern, Gordon A. Ewy. (1999) Vasopressin versus epinephrine during cardiopulmonary resuscitation: a randomized swine outcome study. Resuscitation 41:2, 185-192
CrossRef90
(1999) Epinephrine for Out-of-Hospital Cardiac Arrest. New England Journal of Medicine 340:22, 1763-1765
Full Text91
Rolf Gedeborg, Sten Rubertsson, Lars Wiklund. (1999) Improved haemodynamics and restoration of spontaneous circulation with constant aortic occlusion during experimental cardiopulmonary resuscitation. Resuscitation 40:3, 171-180
CrossRef92
Paul E Sirbaugh, Paul E Pepe, Joan E Shook, Kay T Kimball, Mitchell J Goldman, Mark A Ward, Denise M Mann. (1999) A Prospective, Population-Based Study of the Demographics, Epidemiology, Management, and Outcome of Out-of-Hospital Pediatric Cardiopulmonary Arrest. Annals of Emergency Medicine 33:2, 174-184
CrossRef93
Robert E. O'Connor, David C. Cone, Robert A. De Lorenzo, Robert M. Domeier, Wayne E. Moore, Peter P. Taillac, Vincent P. Verdile, Brian S. Zachariah, Steven J. Davidson. (1999) EMS Systems: Foundations for the Future. Academic Emergency Medicine 6:1, 46-53
CrossRef94
Gueugniaud, Pierre-Yves, Mols, Pierre, Goldstein, Patrick, Pham, Emmanuel, Dubien, Pierre-Yves, Deweerdt, Carine, Vergnion, Michel, Petit, Paul, Carli, Pierre, . (1998) A Comparison of Repeated High Doses and Repeated Standard Doses of Epinephrine for Cardiac Arrest Outside the Hospital. New England Journal of Medicine 339:22, 1595-1601
Full Text95
Carl van Walraven, Ian G Stiell, George A Wells, Paul C Hébert, Katherine Vandemheen. (1998) Do Advanced Cardiac Life Support Drugs Increase Resuscitation Rates From In-Hospital Cardiac Arrest?. Annals of Emergency Medicine 32:5, 544-553
CrossRef96
Colin Robertson (UK), Petter Steen (Norway), Jennifer Adgey (UK), Leo Bossaert (Belgium), Pierre Carli (France), Douglas Chamberlain (UK), Wolfgang Dick (Germany), Lars Ekstrom (Sweden), Svein A Hapnes (Norway), Stig Holmberg (Sweden), Rudolph Juchems (Germany), Fulvio Kette (Italy), Rudy Koster (Netherlands), Francisco J de Latorre (Spain), Karl Lindner (Austria), Narcisco Perales (Spain). (1998) The 1998 European Resuscitation Council guidelines for adult advanced life support. Resuscitation 37:2, 81-90
CrossRef97
M Müllner. (1998) The Influence of Chronic Prearrest Health Conditions on Mortality and Functional Neurological Recovery in Cardiac Arrest Survivors. The American Journal of Medicine 104:4, 369-373
CrossRef98
Joseph Varon, Paul E Marik, Robert E Fromm. (1998) Cardiopulmonary resuscitation: a review for clinicians. Resuscitation 36:2, 133-145
CrossRef99
Daniel M Fatovich, David A Prentice, Geoffrey J Dobb. (1997) Magnesium in cardiac arrest (the magic trial). Resuscitation 35:3, 237-241
CrossRef100
KEITH G. LURIE, KARL H. UNDNER. (1997) Recent Advances in Cardiopulmonary Resuscitation. Journal of Cardiovascular Electrophysiology 8:5, 584-600
CrossRef101
V. Nadkarni, M.F. Hazinski, D. Zideman, J. Kattwinkel, L. Quan, R. Bingham, A. Zaritsky, J. Bland, E. Kramer, J. Tiballs. (1997) Paediatric life support. Resuscitation 34:2, 115-127
CrossRef102
Richard O. Cummins, Douglas Chamberlain, Mary Fran Hazinski, Vinay Nadkarni, Walter Kloeck, Efraim Kramer, Lance Becker, Colin Robertson, Rudi Koster, Arno Zaritsky, Leo Bossaert, Joseph P. Ornato, Victor Callanan, Mervyn Allen, Petter Steen, Brian Connolly, Arthur Sanders, Ahamed Idris, Stuart Cobbe. (1997) Recommended guidelines for reviewing, reporting, and conducting research on in-hospital resuscitation: the in-hospital ‘Utstein style’. Resuscitation 34:2, 151-183
CrossRef103
Karl H Lindner, Burkhard Dirks, Hans-Ulrich Strohmenger, Andreas W Prengel, Ingrid M Lindner, Keith G Lurie. (1997) Randomised comparison of epinephrine and vasopressin in patients with out-of-hospital ventricular fibrillation. The Lancet 349:9051, 535-537
CrossRef104
Charles Brown, Lars Wiklund, Gad Bar-Joseph, Brian Miller, Nicholas Bircher, Norman Paradis, James Menegazzi, Martin von Planta, George C. Kramer, Sven-Erik Gisvold. (1996) Future directions for resuscitation research. IV. Innovative advanced life support pharmacology. Resuscitation 33:2, 163-177
CrossRef105
Schindler, Margrid B., Bohn, Desmond, Cox, Peter N., McCrindle, Brian W., Jarvis, Anna, Edmonds, John, Barker, Geoffrey, . (1996) Outcome of Out-of-Hospital Cardiac or Respiratory Arrest in Children. New England Journal of Medicine 335:20, 1473-1479
Full Text106
A.H.amed H. Idris, L.A.nce B. Becker, Joseph P. Ornato, J.E.rris R. Hedges, Nicholas G. Bircher, Nisha C. Chandra, Richard O. Cummins, Wolfgang Dick, Uwe Ebmeyer, H.E.nry R. Halperin, M.A.ry Fran Hazinski, Richard E. Kerber, Karl B. Kern, P.E.ter Safar, P.E.tter A. Steen, M.Michael Swindle, Joshua E. Tsitlik, Irene von Planta, M.A.rtin von Planta, R.O.bert L. Wears, M.A.x H. Weil. (1996) Utstein-style guidelines for uniform reporting of laboratory CPR research.. Resuscitation 33:1, 69-84
CrossRef107
Joseph P. Ornato, Norman Paradis, Nicholas Bircher, Charles Brown, Herman DeLooz, Wolfgang Dick, William Kaye, Robert Levine, Paul Martens, Robert Neumar, Rita Patel, Paul Pepe, Sivam Ramanathan, Sten Rubertsson, Richard Traystman, Martin von Planta, Vyacheslav Vostrikov, Max Harry Weil. (1996) Future directions for resuscitation research. III. External cardiopulmonary resuscitation advanced life support. Resuscitation 32:2, 139-158
CrossRef108
Carin M. Olson, Kathleen A. Jobe. (1996) Reporting approval by research ethics committees and subjects' consent in human resuscitation research. Resuscitation 31:3, 255-263
CrossRef109
Norman A. Paradis. (1996) Cardiac arrest research in humans — insights into failure. Resuscitation 31:2, 93-100
CrossRef110
I HIGGINSON, D MONTGOMERY, R TUCK. (1996) The use of high doses of adrenaline in paediatric cardiac resuscitation. Journal of Paediatrics and Child Health 32:1, 1-3
CrossRef111
C HOOK, K KOCH. (1996) ETHICS OF RESUSCITATION. Critical Care Clinics 12:1, 135-148
CrossRef112
Bernd Schmitz, Matthias Fischer, Kurt Bockhorst, Mathias Hoehn-Berlage, Konstantin-Alexander Hossmann. (1995) Resuscitation from cardiac arrest in cats: influence of epinephrine dosage on brain recovery. Resuscitation 30:3, 251-262
CrossRef113
S.P. Woodhouse, S. Cox, P. Boyd, C. Case, M. Weber. (1995) High dose and standard dose adrenaline do not alter survival, compared with placebo, in cardiac arrest. Resuscitation 30:3, 243-249
CrossRef114
Kelly J. Tucker, James L. Larson, Ahamed Idris, Anne B. Curtis. (1995) Advanced cardiac life support: Update on recent guidelines and a look at the future. Clinical Cardiology 18:9, 497-504
CrossRef115
Robert W. Neumar, Nicholas G. Bircher, Ka Ming Sim, Fung Xiao, Kathy Swales Zadach, Ann Radovsky, Laurence Katz, Ewe Ebmeyer, Peter Safar. (1995) Epinephrine and sodium bicarbonate during CPR following asphyxial cardiac arrest in rats. Resuscitation 29:3, 249-263
CrossRef116
Michael E. Boczar, Mark A. Howard, Emanuel P. Rivers, Gerard B. Martin, H. Mathilda Horst, Christopher Lewandowski, Michael C. Tomlanovich, Richard M. Nowak. (1995) A technique revisited. Critical Care Medicine 23:3, 498-503
CrossRef117
Catherine Choux, Pierre-Yves Gueugniaud, Alain Barbieux, Emmanuel Pham, Claude Lae, Pierre-Yves Dubien, Paul Petit. (1995) Standard doses versus repeated high doses of epinephrine in cardiac arrest outside the hospital. Resuscitation 29:1, 3-9
CrossRef118
Lars Wik, Petter Andreas Steen, Nicholas G. Bircher. (1994) Quality of bystander cardiopulmonary resuscitation influences outcome after prehospital cardiac arrest. Resuscitation 28:3, 195-203
CrossRef119
Laszlo Littmann, Peter T. Ashline, William J. Hayes, Pal Kempler, Richard M. Raymond, H.James Norton, Robert H. Svenson, Jan R. Tuntelder, George P. Tatsis. (1994) Aminophylline fails to improve the outcome of cardiopulmonary resuscitation from prolonged ventricular fibrillation: A placebo-controlled, randomized, blinded experimental study. Journal of the American College of Cardiology 23:7, 1708-1714
CrossRef120
Norman A. Paradis, Michael I. Rose, Maria S. Gawryl. (1994) Selective aortic perfusion and oxygenation: An effective adjunct to external chest compression-based cardiopulmonary resuscitation. Journal of the American College of Cardiology 23:2, 497-504
CrossRef121
Norman A. Paradis, Michael I. Rose, Utam Garg. (1993) The effect of global ischemia and reperfusion on the plasma levels of vasoactive peptides. The neuroendocrine response to cardiac arrest and resuscitation. Resuscitation 26:3, 261-269
CrossRef122
Charles M. Little, Charles G. Brown. (1993) Angiotensin II improves myocardial blood flow in cardiac arrest. Resuscitation 26:2, 203-210
CrossRef123
Daniel R. Martin, Thomas Gavin, Joseph Bianco, Charles G. Browns, Harlan Stueven, Paul E. Pepe, Richard O. Cummins, Edgar Gonzalez, Michael Jastremski. (1993) Initial countershock in the treatment of asystole. Resuscitation 26:1, 63-68
CrossRef124
Alan Gilston. (1993) CPR and high dose epinephrine. Resuscitation 25:3, 283-284
CrossRef125
(1993) High-Dose Epinephrine in Cardiopulmonary Resuscitation. New England Journal of Medicine 328:10, 735-736
Full Text126
Desforges, Jane F., , Niemann, James T., . (1992) Cardiopulmonary Resuscitation. New England Journal of Medicine 327:15, 1075-1080
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