Abstract 13226: Epinephrine versus Norepinephrine in Cardiac Arrest Patients With Postresuscitation Shock

Autor: Wulfran Bougouin, Kaci Slimani, Marie Renaudier, Yannick Binois, Marine Paul, Florence Dumas, Lionel Lamhaut, Thomas Loeb, Sofia Ortuno, Nicolas Deye, Sebastian Voicu, Frankie BEGANTON, daniel jost, Armand Mekontso-Dessap, Eloi Marijon, Xavier JOUVEN, Nadia Aissaoui, Alain Cariou
Rok vydání: 2021
Předmět:
Zdroj: Circulation. 144
ISSN: 1524-4539
0009-7322
DOI: 10.1161/circ.144.suppl_2.13226
Popis: Backgound: Whether epinephrine or norepinephrine is preferable as the continuous intravenous vasopressor used to treat postresuscitation shock is unclear. Objectives: To compare outcomes of patients with postresuscitation shock after out-of-hospital cardiac arrest according to whether the continuous intravenous vasopressor used was epinephrine or norepinephrine. Methods: We conducted an observational multicenter study of consecutive patients managed in 2011-2018 for postresuscitation shock. The primary outcome was all-cause hospital mortality, and secondary outcomes were cardiovascular hospital mortality and unfavorable neurological outcome (Cerebral Performance Category 3 to 5). A multivariate regression analysis and a propensity score analysis were performed, as well as several sensitivity analyses. Results: Of the 766 patients included in five hospitals, 285 (37%) received epinephrine and 481 (63%) norepinephrine. All-cause hospital mortality was significantly higher in the epinephrine group (OR 2.6; 95%CI, 1.4-4.7; P =0.002). Cardiovascular hospital mortality was also higher with epinephrine (aOR 5.5; 95%CI 3.0-10.3; P P =0.02). Conclusions: Among patients with postresuscitation shock after out-of-hospital cardiac arrest, use of epinephrine was associated with higher all-cause and cardiovascular-specific mortality, compared with norepinephrine infusion. A randomized controlled trial comparing the two vasopressors in this population is warranted.
Databáze: OpenAIRE
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