Mustafa SABAK, Behçet AL, Mehmet Murat OKTAY, Mustafa BOĞAN, Hasan GÜMÜŞBOĞA, Suat ZENGİN, Şevki Hakan EREN, Mehmet Mustafa SUNAR, Özlem BİNGÖL, Tanyeli Güneyligil KAZAZ

The Effect of Epinephrine Administration on Return of Spontaneous Circulation and One-Month Mortality with Cardiopulmonary Arrest Patients

Objective: The objective of this study is to determine the effect of epinephrine administration on the return of spontaneous circulation (ROSC) and one-month mortality in patients with cardiopulmonary arrest.Methods: We conducted this study between August 1, 2016 and May 31, 2017. Importantly, we included the witnessed cases (≥18years) of in-emergency department cardiopulmonary arrest (IEDCA) and out-of-hospital cardiopulmonary arrest (OHCA) in thestudy. We divided the patients into two groups: the adrenaline group (Group 1) and the non-adrenaline group (Group 2). Thereafter, we investigated ROSC and one-month mortality in them.Results: We included 183 patients (50.3% of males and 49.7% of females with a mean age of 64.2±16.8 years) in the study. Thepercentages of IEDCA and OHCA cases were 25.1% and 74.9%, respectively. Epinephrine was administered to 100 (54.6%) patients(Group 1). Among these patients, 15.9% (n=29) of the patients had shockable rhythms (ventricular fibrillation, pulseless ventriculartachycardia) and 84.1% (n=154) of them had non-shockable rhythms (asystole, pulseless electrical activity) as the initial rhythm.ROSC and one-month mortality rate of these patients were 24% (n=44) and 72.8% (n=36), respectively. The one-month mortalityrates of Group 1 (30% of patients had IEDCA and 70% of patients had OHCA) and Group 2 were 43.8% and 56.2%, respectively(p=0.0231). The ROSC and one-month mortality rates of Group 1 and Group 2 cases, whose initial rhythm was a shockable rhythm,were 26.6% and 50% vs. 42.8% and 66.6%, respectively.Conclusion: In this study, we found no significant difference in terms of obtaining ROSC between the shockable rhythm and ROSCin the IEDCA and OHCA cases (p=0.963 and p=0.141, respectively). The effect of epinephrine administration on patients with IEDCA and OHCA whose ROSC was obtained on one-month mortality was not statistically significant (p>0.05).

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