J Korean Soc Emerg Med.  2014 Oct;25(5):542-549. 10.0000/jksem.2014.25.5.542.

Is Atropine Necessary for Cardiopulmonary Resuscitation?

• Lee HW
• Park DH
• Yoon YS
• Kim YW
• Lee J
• Park KH
• Kwon IH
• Yeo WH
• Park HY
• Cho J

• KMID: 2333985
• DOI: http://doi.org/10.0000/jksem.2014.25.5.542

Abstract

PURPOSE
According to the 2010 guidelines for cardiopulmonary resuscitation (CPR) of the American Heart association, administration of atropine for non-shockable rhythm is no longer recommended, however, there are insufficient data in humans. This study was conducted to evaluate the results of CPR, whether the combined administration of atropine and epinephrine (Atropine combined group, AG) compared with epinephrine only injection (epinephrine only group, EG) for patients with non-shockable rhythm.
METHODS
A total of 449 patients who underwent CPR in the emergency department from 2009 to 2012 were included. Retrospective analysis was performed according to atropine administration during CPR. We investigated Return of Spontaneous Circulation (ROSC), sustained ROSC, 30-day survival, and 30-day neurological outcome using Utstein templates.
RESULTS
There were 178 (48.9%) patients in the AG. There were no significant differences in the baseline characteristics. The two groups had similar rates of ROSC, sustained ROSC, and 30-day survival. However, AG had a significantly poor neurological outcome compared to EG, with an adjusted odds ratio of 0.074 (95% CI 0.012-0.452, p=0.005).
CONCLUSION
The combination therapy of atropine and epinephrine during CPR showed poor neurological outcome compared with epinephrine alone. Atropine is not useful for adults with non-shockable rhythm in terms of 30-day neurological outcome.

Keyword

Cardiac arrest; Cardiopulmonary resuscitation; Atropine

MeSH Terms

Adult
American Heart Association
Atropine*
Cardiopulmonary Resuscitation*
Emergency Service, Hospital
Epinephrine
Heart Arrest
Humans
Odds Ratio
Retrospective Studies
Atropine
Epinephrine