Impact of early intravenous epinephrine administration on outcomes following out-of-hospital cardiac arrest

Hayashi, Yasuyuki; Iwami, Taku; Kitamura, Tetsuhisa; Nishiuchi, Tatsuya; Kajino, Kentaro; Sakai, Tomohiko; Nishiyama, Chika; Nitta, Masahiko; Hiraide, Atsushi; Kai, Tatsuro

doi:https://doi.org/10.1253/circj.CJ-11-1433

Impact of early intravenous epinephrine administration on outcomes following out-of-hospital cardiac arrest

Hayashi, Yasuyuki; Iwami, Taku; Kitamura, Tetsuhisa et al.

Circulation Journal, 2012, 76(7), 1639-1645

アクセス数:956件（2025-10-24 04:15 集計）

固定URL: https://hdl.handle.net/11094/78935

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タイトル	Impact of early intravenous epinephrine administration on outcomes following out-of-hospital cardiac arrest
著者	著者名 Hayashi, Yasuyuki
	NRID 1000060437291 1000060437291 著者名 Iwami, Taku
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 著者名 Kitamura, Tetsuhisa
	NRID 1000060588804 1000060588804 著者名 Nishiuchi, Tatsuya
	著者名 Kajino, Kentaro
	NRID 1000050456985 1000050456985 researchmap permalink sakaitomohiko sakaitomohiko Scopus Author ID 35746769000 35746769000 著者名 Sakai, Tomohiko
	NRID 1000040584842 1000040584842 著者名 Nishiyama, Chika
	NRID 1000010411349 1000010411349 著者名 Nitta, Masahiko
	NRID 1000020199037 1000020199037 著者名 Hiraide, Atsushi
	著者名 Kai, Tatsuro
キーワード等	Cardiac arrest
	Cardiopulmonary resuscitation
	Epidemiology
	Epinephrine
	Sudden death
内容	Yasuyuki Hayashi, Taku Iwami, Tetsuhisa Kitamura, Tatsuya Nishiuchi, Kentaro Kajino, Tomohiko Sakai, Chika Nishiyama, Masahiko Nitta, Atsushi Hiraide, Tatsuro Kai, Impact of Early Intravenous Epinephrine Administration on Outcomes Following Out-of-Hospital Cardiac Arrest, Circulation Journal, 2012, Volume 76, Issue 7, Pages 1639-1645, Released June 25, 2012, [Advance publication] Released April 05, 2012, Online ISSN 1347-4820, Print ISSN 1346-9843, https://doi.org/10.1253/circj.CJ-11-1433, https://www.jstage.jst.go.jp/article/circj/76/7/76_CJ-11-1433/_article/-char/en
抄録	Background: The effectiveness of epinephrine administration for cardiac arrests has been shown in animal models, but the clinical effect is still controversial. Methods and Results: A prospective, population-based, observational study in Osaka involved consecutive outof- hospital cardiac arrest (OHCA) patients from January 2007 through December 2009. We evaluated the outcomes among adult non-traumatic bystander-witnessed OHCA patients for whom the local protocol directed the emergency medical service personnel to administer epinephrine. After stratifying by first documented cardiac rhythm, outcomes were compared among the following groups: non-administration, ≤10, 11-20 and ≥21 min as the time from emergency call to epinephrine administration. A total of 3,161 patients were eligible for our analyses, among whom 1,013 (32.0%) actually received epinephrine. The epinephrine group had a significantly lower rate of neurologically intact 1-month survival than the non-epinephrine group (4.1% vs. 6.1%, P=0.028). In cases of ventricular fibrillation (VF) arrest, patients in the early epinephrine group who received epinephrine administration within 10 min had a significantly higher rate of neurologically intact 1-month survival compared with the non-epinephrine group (66.7% vs. 24.9%), though other epinephrine groups did not. In cases of non-VF arrest, the rate of neurologically intact 1- month survival was low, irrespective of epinephrine administration. Conclusions: The effectiveness of epinephrine after OHCA depends on the time of administration. When epinephrine is administered in the early phase, there is an improvement in neurological outcome from OHCA with VF.
出版者	Japanese Circulation Society
収録物名	Circulation Journal
巻(号)	76(7)
ページ	1639-1645
刊行年月	2012-06-25
言語	英語
ハンドルURL	https://hdl.handle.net/11094/78935
PISSN	13469843
eISSN	13474820
NCID	AA11591968
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1253/circj.CJ-11-1433
関連情報 (isIdenticalTo)	PMID 22481099
アクセス権	open access
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCTERMS.bibliographicCitation	Circulation Journal. 2012, 76(7), p. 1639-1645
DC.title	Impact of early intravenous epinephrine administration on outcomes following out-of-hospital cardiac arrest
DC.creator	Hayashi, Yasuyuki
	Iwami, Taku
	Kitamura, Tetsuhisa
	Nishiuchi, Tatsuya
	Kajino, Kentaro
	Sakai, Tomohiko
	Nishiyama, Chika
	Nitta, Masahiko
	Hiraide, Atsushi
	Kai, Tatsuro
DC.publisher	Japanese Circulation Society
DC.language' scheme='DCTERMS.RFC1766	英語
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2012-06-25
DC.identifier	https://doi.org/10.1253/circj.CJ-11-1433
DC.subject	Cardiac arrest
	Cardiopulmonary resuscitation
	Epidemiology
	Epinephrine
	Sudden death
DC.description	Yasuyuki Hayashi, Taku Iwami, Tetsuhisa Kitamura, Tatsuya Nishiuchi, Kentaro Kajino, Tomohiko Sakai, Chika Nishiyama, Masahiko Nitta, Atsushi Hiraide, Tatsuro Kai, Impact of Early Intravenous Epinephrine Administration on Outcomes Following Out-of-Hospital Cardiac Arrest, Circulation Journal, 2012, Volume 76, Issue 7, Pages 1639-1645, Released June 25, 2012, [Advance publication] Released April 05, 2012, Online ISSN 1347-4820, Print ISSN 1346-9843, https://doi.org/10.1253/circj.CJ-11-1433, https://www.jstage.jst.go.jp/article/circj/76/7/76_CJ-11-1433/_article/-char/en
DCTERMS.abstract	Background: The effectiveness of epinephrine administration for cardiac arrests has been shown in animal models, but the clinical effect is still controversial. Methods and Results: A prospective, population-based, observational study in Osaka involved consecutive outof- hospital cardiac arrest (OHCA) patients from January 2007 through December 2009. We evaluated the outcomes among adult non-traumatic bystander-witnessed OHCA patients for whom the local protocol directed the emergency medical service personnel to administer epinephrine. After stratifying by first documented cardiac rhythm, outcomes were compared among the following groups: non-administration, ≤10, 11-20 and ≥21 min as the time from emergency call to epinephrine administration. A total of 3,161 patients were eligible for our analyses, among whom 1,013 (32.0%) actually received epinephrine. The epinephrine group had a significantly lower rate of neurologically intact 1-month survival than the non-epinephrine group (4.1% vs. 6.1%, P=0.028). In cases of ventricular fibrillation (VF) arrest, patients in the early epinephrine group who received epinephrine administration within 10 min had a significantly higher rate of neurologically intact 1-month survival compared with the non-epinephrine group (66.7% vs. 24.9%), though other epinephrine groups did not. In cases of non-VF arrest, the rate of neurologically intact 1- month survival was low, irrespective of epinephrine administration. Conclusions: The effectiveness of epinephrine after OHCA depends on the time of administration. When epinephrine is administered in the early phase, there is an improvement in neurological outcome from OHCA with VF.
DC.format	78935
citation_title	Impact of early intravenous epinephrine administration on outcomes following out-of-hospital cardiac arrest
citation_author	Hayashi, Yasuyuki
	Iwami, Taku
	Kitamura, Tetsuhisa
	Nishiuchi, Tatsuya
	Kajino, Kentaro
	Sakai, Tomohiko
	Nishiyama, Chika
	Nitta, Masahiko
	Hiraide, Atsushi
	Kai, Tatsuro
citation_publisher	Japanese Circulation Society
citation_language	英語
citation_date	2012-06-25
citation_journal_title	Circulation Journal
citation_volume	76
citation_issue	7
citation_firstpage	1639
citation_lastpage	1645
citation_doi	https://doi.org/10.1253/circj.CJ-11-1433
citation_pmid	22481099
citation_public_url	https://hdl.handle.net/11094/78935

Impact of early intravenous epinephrine administration on outcomes following out-of-hospital cardiac arrest

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