Cardiac arrest & resuscitation
Epinephrine Before Defibrillation in Children With Initially Shockable In-Hospital Cardiac Arrest
Main finding · Survival to hospital dischargeResult — go to the resultOR for survival to hospital discharge 0.84 CI 0.46–1.56Authors' conclusion
Although survival outcomes were numerically lower in epinephrine before defibrillation group, the association was not statistically significant.
Study context
- Population
- Children (< 18 yr) with index in-hospital cardiac arrest (IHCA) with initial shockable rhythm (VF or pulseless VT) and ≥1 defibrillation attempt, AHA Get With the Guidelines-Resuscitation Registry, 2000–2020351 (71%) in ICU
- Participants
- 492 children
- Exposure
- Epinephrine before or during the same minute as defibrillation vs not
- Outcome
- Survival to hospital discharge
Methodological detailspropensity-score matched, registry
- Propensity-score matched
- Registry
Main finding
As reported in the abstract
OR for survival to hospital discharge
0.84
CI 0.46–1.56
By group
Epinephrine before or during the same minute as defibrillation vs Comparison
OR for survival to hospital discharge 0.84 (CI 0.46–1.56)
Observational data: associations, not effects.
Further findings
| Outcome | Epinephrine before or during the same minute as defibrillation | Comparison | Estimate | |
|---|---|---|---|---|
| ROSC ≥ 20 minPropensity-score matched · per-group proportions unadjusted | 74.6% | 84.6% | OR for ROSC 0.97 (CI 0.48–1.96) | |
| Survival with favourable neurologic outcomePropensity-score matched · per-group proportions unadjusted | 22.1% | 40.4% | OR for favourable neurologic outcome 0.52 (CI 0.27–1.00) | |
| 0.20.5125Ratio (log scale) |
- Return of spontaneous circulation (ROSC) ≥ 20 min: OR >1 favours epinephrine group (event = ROSC)
- Survival with favourable neurologic outcome: OR >1 favours epinephrine group (event = favourable outcome)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Epinephrine Before Defibrillation in Children With Initially Shockable In-Hospital Cardiac Arrest. Crit Care Med. Published 30 July 2025. doi:10.
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