Prospective trials are needed to determine the correct dose, timing and patients for epinephrine in cardiac arrest. The available clinical data confirm that epinephrine administration during CPR can increase short-term survival (return of pulses), but point towards either no benefit or even harm of this drug for more patient-centred outcomes (long-term survival or functional recovery). Laboratory data suggest that harmful epinephrine-induced reductions in microvascular blood flow during and after CPR may offset the beneficial epinephrine-induced increase in arterial blood pressure during CPR. Adrenaline prepares the body to either fight or flee from danger by increasing blood circulation and breathing. It is the hormone that triggers the fight-or-flight response. Detrimental effects were greatest in patients found in ventricular fibrillation. Adrenaline, also known as epinephrine, is a type of hormone that is released whenever a person experiences fear, anxiety, or stress. Very large, well-controlled, observational studies suggest that, despite increases in return of pulses, epinephrine reduces long-term survival and functional recovery after CPR. Recent studies question whether epinephrine provides any overall benefit for patients.Ī randomized controlled trial indicates that epinephrine for out-of-hospital cardiac arrest increases return of pulses, but does not significantly alter longer-term survival. However, the dose, timing and indications for epinephrine use are based on limited animal data. Epinephrine increases arterial blood pressure and coronary perfusion during CPR via alpha-1-adrenoceptor agonist effects. Epinephrine is the primary drug administered during cardiopulmonary resuscitation (CPR) to reverse cardiac arrest.

Adrenaline function