Prehospital epinephrine aids out-of-hospital pediatric cardiac arrests
Prehospital administration of epinephrine may aid pediatric patients following out-of-hospital cardiac arrests (OHCAs), according to a study published in the Jan. 21 issue of the Journal of the American College of Cardiology.
Tasuku Matsuyama, M.D., Ph.D., from the Kyoto Prefectural University of Medicine in Japan, and colleagues assessed the effect of prehospital epinephrine administration by emergency medical service personnel among pediatric patients (aged 8 to 17 years) with OHCA between 2007 and 2016.
The researchers identified 3,961 pediatric patients with OHCA, of whom 7.7 percent received epinephrine. A total of 608 patients were included after time-dependent propensity score-sequential matching. In the matched cohort, there were no significant noted differences between the epinephrine and no-epinephrine groups in one-month survival (epinephrine: 10.2 percent; no epinephrine: 7.9 percent; risk ratio [RR], 1.13; 95 percent confidence interval [CI], 0.67 to 1.93). Favorable neurological outcomes were also similar (epinephrine: 3.6 percent; no epinephrine: 2.6 percent; RR, 1.56; 95 percent CI, 0.61 to 3.96). However, the epinephrine group had a higher likelihood of achieving prehospital return of spontaneous circulation (epinephrine: 11.2 percent; no epinephrine: 3.3 percent; RR, 3.17; 95 percent CI, 1.54 to 6.54).
"We recommend that prehospital epinephrine administration should be included in international guidelines for cardiopulmonary resuscitation to enhance the survival of pediatric OHCA patients," a coauthor said in a statement.
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