Several research studies have looked at the use of adrenaline as a treatment for cardiac arrest. However, more high-quality evidence is needed to decide whether it should continue to be used in the treatment of cardiac arrest.

Summary of Research

The diagram below shows a summary of the research studies that have looked at the effect of adrenaline on survival to hospital discharge and risk of brain damage:

	Adrenaline made no difference to survival Jacobs et al, 2011Link opens in a new window	Adrenaline was associated with a worse survival rate Dumas et al, 2014Link opens in a new window
Adrenaline was associated with a better survival rate in a subgroup with a non-shockable heart rhythm Nakahara et al, 2013Link opens in a new window	Adrenaline made no difference to survival or to the risk of severe brain damage Machida et al, 2012Link opens in a new window	Adrenaline was associated with a worse survival rate Herlitz et al, 1995Link opens in a new window	Adrenaline was associated with a worse survival rate and increased risk of severe brain damage Olasveengen et al, 2012Link opens in a new window
	Adrenaline made no difference to survival Woodhouse et al, 1995Link opens in a new window	Adrenaline was associated with a worse survival rate Holmberg et al, 2002Link opens in a new window	Adrenaline was associated with a worse survival rate and increased risk of severe brain damage Hagihara et al, 2012Link opens in a new window
	Adrenaline made no difference to survival Ong et al, 2007Link opens in a new window	Adrenaline made no difference to survival, but increased the risk of severe brain damage Hayashi et al, 2012Link opens in a new window

As you can see above, only one study showed an increase in survival and therefore a benefit to patients. The rest of the studies show either no difference in the chance of survival or harm when adrenaline is used.

Clinical trial needed

Many international experts have called for a larger clinical trial Link opens in a new windowwhich can answer the question is adrenaline (epinephrine) helpful or harmful. The articles written about this important question can be read on the following links:

• Is Epinephrine During Cardiac Arrest Associated With Worse Outcomes in Resuscitated Patients?Link opens in a new window
• Epinephrine in Out-of- Hospital Cardiac ArrestLink opens in a new window
• Epinephrine in out-of-hospital cardiac arrest: A critical reviewLink opens in a new window
• Adrenaline for out-of-hospital cardiac arrest resuscitation: A systematic review and meta-analysis of randomised controlled trialsLink opens in a new window
• Effect of epinephrine on survival after cardiac arrest: a systematic review and meta-analysisLink opens in a new window
• Adrenaline for out of hospital cardiac arrest?Link opens in a new window
• Is adrenaline safe and effective as a treatment for out of hospital cardiac arrest?Link opens in a new window

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