Up to one third of patients with out-of-hospital cardiac arrest(OHCA) have impaired myocardial contractility and vasodilatation. The mainstay of treatment is either adrenaline or noradrenaline.
Adrenaline through its beta effects is thought to increased myocardial oxygen demand and the risk of ventricular arrhythmias and several studies have found an increased mortality and risk of re-arrest in comparison to noradrenaline (1-4)
What They did
This study(5) compare the outcomes of patients with out-of-hospital cardiac arrest who received adrenaline vs noradrenaline as a post-resuscitation vasopressor by emergency medical services clinicians.
It was a retrospective cohort study using a multi-centre, pre-hospital data-base, using ‘target trial emulation’ (emulates a target trial and improves quality of observational studies).
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