| Abstract [eng] |
Background: Cardiac arrest remains a significant global health concern, for every health professional to encounter in ones career demanding prompt and effective intervention to improve patient outcomes. Epinephrine, a potent sympathomimetic agent, has long been a cornerstone in the pharmacological management of cardiac arrest. This paper provides a comprehensive overview of the use of epinephrine in cardiac resuscitation, focusing on its mechanisms of action, efficacy and potential adverse effects. Methods: This study aims to provide inside into the complexity of epinephrine usage in cardiopulmonary resuscitation (CPR), exploring its pharmacodynamics, pharmacokinetics, and impact on patient outcomes in form of a narrative literature review. By establishing a foundation in these areas, the study seeks to understand the medication's efficacy and safety profile, considering factors like timing, dosage, and long-term effects. The analysis includes a critical evaluation of studies such as PARAMEDIC2, examining their implications for clinical practice. Through a narrative literature review, the study synthesizes recent research findings and guidelines to examine optimal epinephrine administration in CPR scenarios, highlighting the ongoing evolution of resuscitative practices. Results: Epinephrine acts primarily through its potent vasoconstrictive and inotropic effects, aiming to restore perfusion pressure and myocardial contractility during cardiac arrest. Numerous clinical studies have evaluated its role in resuscitation protocols, demonstrating transient improvements in return of spontaneous circulation (ROSC) rates. However, the neurological outcomes remain controversial, with conflicting evidence from observational studies and randomized controlled trials. Concerns have been raised regarding its potential detrimental effects on neurological outcomes, including increased cerebral oxygen consumption and neuronal injury. Conclusion: Despite these controversies, epinephrine continues to be recommended in international resuscitation guidelines as a key intervention during cardiac arrest. Epinephrine remains the preferred drug and should be administered without further delay during cardiopulmonary resuscitation. |
