Cardiac arrest & resuscitation
Naloxone administration associated with improved survival in PEA out-of-hospital cardiac arrests
Authors' conclusion
In this national cohort, naloxone administration was associated with improved survival to hospital discharge for OHCA patients in PEA. No association was found between naloxone and clinical outcomes for OHCA patients with shockable rhythms or asystole.
Study context
- Population
- OHCA patients, US ESO Data Collaborative 2019–2020, classified a priori by presenting rhythm (shockable, PEA, asystole)cases analysed
- Participants
- 40,333 patients
- Exposure
- Prehospital naloxone vs no naloxone, stratified by presenting rhythm
- Naloxonen = 7,567
- Outcome
- Prehospital ROSC and survival to hospital discharge, stratified by presenting rhythm
Methodological detailspropensity-score matched, national registry (ESO Data Collaborative), Retrospective design: selection bias and resuscitation time bias not fully addressed; causality cannot be inferred
- Propensity-score matched
- National registry (ESO Data Collaborative)
- Retrospective design: selection bias and resuscitation time bias not fully addressed; causality cannot be inferred
Main finding
As reported in the abstract
Survival to hospital discharge and prehospital ROSC, PEA (after propensity-score matching)
Naloxone vs No naloxoneEstimate (95% CI)
PEA
OR for survival to hospital discharge 1.46(1.11–1.92)
PEA; similar rates
OR for prehospital ROSC 1.09(0.90–1.31)
Observational data: associations, not effects.
Further findings
Overall outcomes before matching (all cases)
- Prehospital ROSC
- 21.5%
- Survival to hospital discharge
- 9.0%
Original publication
Naloxone administration associated with improved survival in PEA out-of-hospital cardiac arrests. Resuscitation. Published 22 May 2026. doi:10.
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