Evidence map›Paper›PMID 38124126›Full record

ArticleCritical care (London, England)2023

Cumulative dose of epinephrine and mode of death after non-shockable out-of-hospital cardiac arrest: a registry-based study.

François Javaudin, Wulfran Bougouin, Lucie Fanet, Jean-Luc Diehl, Daniel Jost, Frankie Beganton, Jean-Philippe Empana, Xavier Jouven, Frédéric Adnet, Lionel Lamhaut and 4 more

Open access · goldAbstract read
In one paragraph

Article in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Intra-aortic adrenaline titration during cardiac arrest.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 1 country.

François JavaudinParis Sudden Death Expertise Center, 75015, Paris, France. francois.javaudin@chu-nantes.fr.ORCID 0000-0002-7728-2320
Wulfran BougouinParis Sudden Death Expertise Center, 75015, Paris, France.
Lucie FanetParis Sudden Death Expertise Center, 75015, Paris, France.
Jean-Luc DiehlMedical Intensive Care Unit, AP-HP, European Georges Pompidou Hospital, 75015, Paris, France.
Daniel JostParis Sudden Death Expertise Center, 75015, Paris, France.
Frankie BegantonParis Sudden Death Expertise Center, 75015, Paris, France.
Jean-Philippe EmpanaParis Sudden Death Expertise Center, 75015, Paris, France.
Xavier JouvenParis Sudden Death Expertise Center, 75015, Paris, France.
Frédéric AdnetParis Sudden Death Expertise Center, 75015, Paris, France.
Lionel LamhautParis Sudden Death Expertise Center, 75015, Paris, France.
Jean-Baptiste LascarrouParis Sudden Death Expertise Center, 75015, Paris, France.
Alain CariouParis Sudden Death Expertise Center, 75015, Paris, France.
Florence DumasParis Sudden Death Expertise Center, 75015, Paris, France.
Sudden Death Expertise Center investigators
Inserm · FRAssistance Publique – Hôpitaux de Paris · FRHôpital Cochin · FRCentre Hospitalier Universitaire de Nantes · FRNantes Université · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEpinephrine increases the chances of return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA), especially when the initial rhythm is non-shockable. However, this drug could also worsen the post-resuscitation syndrome (PRS). We assessed the association between epinephrine use during cardiopulmonary resuscitation (CPR) and subsequent intensive care unit (ICU) mortality in patients with ROSC after non-shockable OHCA.

methodsWe used data prospectively collected in the Sudden Death Expertise Center (SDEC) registry (capturing OHCA data located in the Greater Paris area, France) between May 2011 and December 2021. All adults with ROSC after medical, cardiac and non-cardiac causes, non-shockable OHCA admitted to an ICU were included. The mode of death in the ICU was categorized as cardiocirculatory, neurological, or other.

resultsOf the 2,792 patients analyzed, there were 242 (8.7%) survivors at hospital discharge, 1,004 (35.9%) deaths from cardiocirculatory causes, 1,233 (44.2%) deaths from neurological causes, and 313 (11.2%) deaths from other etiologies. The cardiocirculatory death group received more epinephrine (4.6 ± 3.8 mg versus 1.7 ± 2.8 mg, 3.2 ± 2.6 mg, and 3.5 ± 3.6 mg for survivors, neurological deaths, and other deaths, respectively; p < 0.001). The proportion of cardiocirculatory death increased linearly (R

conclusionsIn non-shockable OHCA with ROSC, the dose of epinephrine used during CPR is strongly associated with early cardiocirculatory death. Further clinical studies aimed at limiting the dose of epinephrine during CPR seem warranted. Moreover, strategies for the prevention and management of PRS should take this dose of epinephrine into consideration for future trials.

Indexed as

Cardiopulmonary ResuscitationEmergency Medical ServicesOut-of-Hospital Cardiac ArrestAdultEpinephrineHumansRegistriesEpinephrineCardiac arrestCardiocirculatory deathEpinephrineNon-shockable OHCAPost-resuscitation shock

Identifiers

PMID38124126
PMCPMC10734153
OpenAlexW4389991350

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.