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Adrenaline treatment for cardiac arrest risks brain damage

Monday 23rd July 2018
A new study has brought into question the value of using adrenaline to treat cardiac arrest patients.
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Using adrenaline to treat cardiac arrest seldom leads to recovery and among those who do survive long enough to leave hospital, the risk of brain damage are doubled. 

These were the key findings of a study by the University of Warwick Medical School, which investigated the cases of 8,000 patients in England and Wales. The research, published in the New England Journal of Medicine, disclosed that the use of adrenaline increased recovery rates by less than one per cent. 

It was carried out over a three-year period, with 4,012 of the patients being given adrenaline. Only 3.2 per cent of this group - 30 in all - were still alive 30 days later. At the same time, 3,995 patients were given a saltwater treatment by paramedics and 94 were still living a month later - 2.4 per cent of the total. 

Moreover, of those who were discharged from hospital, 39 of those given adrenaline had brain damage, compared to only 16 who had the placebo. 

For more than 60 years, adrenaline has routinely been used as a last resort when other treatments for cardiac arrest such as cardiopulmonary resuscitation (CPR) and defibrillation, have failed. However, these findings bring into question the value of its use; with very few surviving and those who do being at high risk of severe health problems thereafter, the focus of policy on resuscitation may now shift in the light of this evidence. 

Co-author of the report Professor Gavin Perkins said: "Patients may be less willing to accept burdensome treatments if the chances of recovery are small or the risk of survival with severe brain damage is high.

"The findings of this trial will require careful consideration by the wider community and those responsible for clinical practice guidelines for cardiac arrest."

In response to the report, the Resuscitation Council, which issues guidelines to medical practitioners in the UK, said it would carefully examine the findings before deciding whether to revise its guidance.

Written by Matthew Horton

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