Real-time hemodynamic responses to epinephrine and their association with return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest
Authors' conclusion
Greater delta DBP and delta MAP following epinephrine administration during cardiopulmonary resuscitation were associated with higher likelihood of achieving sustained ROSC in patients with OHCA.
Study context
- Population
- Patients with Out-of-hospital cardiac arrest (OHCA) treated at a tertiary hospital with invasive arterial BP monitoring during resuscitation in the EDincluded in the analysis
- Participants
- 160 patients
- Exposure
- Sustained ROSC vs no ROSC: BP changes after epinephrine
- Outcome
- Sustained ROSC (ROSC maintained for at least 20 min)
Methodological detailssingle tertiary hospital
- Single tertiary hospital
Main finding
As reported in the abstract
Delta BP (15-0 s before vs 165-180 s after epinephrine) and sustained ROSC (≥20 min)
Estimate (95% CI)P value
ROSC vs no-ROSC
median difference in delta DBP 13.7 mmHg(11.3–13.8)
P = 0.001ROSC vs no-ROSC
median difference in delta MAP 14.9 mmHg(12.6–15.7)
P = 0.001Estimate (95% CI)P value
Delta DBPmultivariable analysis
aOR for achieving sustained ROSC, per unit delta DBP 1.02(1.00–1.04)
P = 0.040Delta MAPmultivariable analysis
aOR for achieving sustained ROSC, per unit delta MAP 1.01(1.00–1.03)
P = 0.010Observational data: associations, not effects.
Original publication
Real-time hemodynamic responses to epinephrine and their association with ROSC in out-of-hospital cardiac arrest. Resuscitation. Published 16 April 2025. doi:10.
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