STANDARD DOSES VERSUS REPEATED HIGH-DOSES OF EPINEPHRINE IN CARDIAC-ARREST OUTSIDE THE HOSPITAL

被引：70

作者：

CHOUX, C ^{[1
]}

GUEUGNIAUD, PY ^{[1
]}

BARBIEUX, A ^{[1
]}

PHAM, E ^{[1
]}

LAE, C ^{[1
]}

DUBIEN, PY ^{[1
]}

PETIT, P ^{[1
]}

机构：

[1] HOP EDOUARD HERRIOT,SAMU 69,F-69437 LYON 03,FRANCE

来源：

RESUSCITATION | 1995年 / 29卷 / 01期

关键词：

OUT-OF-HOSPITAL CARDIAC ARREST; EPINEPHRINE;

D O I：

10.1016/0300-9572(94)00810-3

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Among all of the cathecolamines used for cardiac arrest treatment, epinephrine injection during cardio-pulmonary resuscitation is currently the most powerful means of enhancing effectiveness; however, deliberations about the optimal dosage have recently become intense. In the SAMU of Lyon (F), we conducted a double blind prospective randomized study over an 18-month period, comparing repeated standard-dose epinephrine (1 mg) and repeated high-dose epinephrine (5 mg) in the management of cardiac arrest outside the hospital. Five-hundred thirty-six patients were enrolled with 265 in the standard-dose group and 271 in the high-dose group; both groups are globally similar. One-hundred eighty-one (33.8%) patients returned to spontaneous circulation (R.O.S.C.); 85 in the standard-dose group (32%) and 96 in the high-dose group (35.5%). One-hundred nineteen patients (22.2%) were admitted; 54 in the standard-dose group (20.4%) and 65 in the high-dose group (24%). At 6 months nine patients (7.6%) were alive; three patients from the standard-dose group (5.5%) and six from the high-dose group (9.2%). We never noticed cardiac or neurologic adverse effects with the high doses. The results of this study are not statistically significant, but we observed a marginal trend towards repeated 5 mg epinephrine doses. A large French multicentre study is now necessary.

引用

页码：3 / 9

页数：7

共 18 条

[1] Standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care, JAMA: The Journal of the American Medical Association, 244, pp. 453-509, (1980)
[2] Standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care, JAMA: The Journal of the American Medical Association, 255, pp. 2905-2992, (1986)
[3] Standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care, J Am Med Assoc, 268, pp. 2205-2211, (1992)
[4] ALS working party of the ERC, Guidelines for advanced life support, Resuscitation, 24, pp. 111-121, (1992)
[5] Crile, Dolley, An experimental research into the resuscitation of dogs killed by anesthesics and asphyxia, Journal of Experimental Medicine, 8, pp. 713-725, (1906)
[6] Gueugniaud, L'adrénaline dans l'arrêt circulatoire. Quelles doses aujourd'hui?, JEUR, 6, pp. 51-53, (1993)
[7] Gueugniaud, Theurey, Vaudelin, Rochette, Petit, Peripheral versus central intravenous lines in emergency cardiac care, Lancet, 8558, (1987)
[8] Gueugniaud, Theurey, Petit, L'adrénaline dans l'arrêt cardiaque: les doses classiques ne sont-elles pas dépassées?, Presse Med, 17, (1988)
[9] Gueugniaud, Vaudelin, Gaussorgues, Petit, Out-of hospital cardiac arrest: the teaching of experience of the SAMU of Lyon, Resuscitation, 17, pp. S79-S98, (1989)
[10] Gueugniaud, Theurey, Vaudelin, Choux, Prost, Petit, Approche clinique de l'efficacité de l'adrénaline à fortes doses dans l'arrêt circulatoire, JEUR, 4, pp. 255-260, (1990)

← 1 2 →