Author:
Aldujeli Ali,Haq Ayman,Tecson Kristen M.,Kurnickaite Zemyna,Lickunas Karolis,Bailey Som,Tatarunas Vacis,Braukyliene Rima,Baksyte Giedre,Aldujeili Montazar,Khalifeh Hussein,Briedis Kasparas,Ordiene Rasa,Unikas Ramunas,Hamadeh Anas,Brilakis Emmanouil S.
Abstract
Abstract
Background
Epinephrine is routinely utilized in cardiac arrest; however, it is unclear if the route of administration affects outcomes in acute myocardial infarction patients with cardiac arrest.
Objectives
To compare the efficacy of epinephrine administered via the peripheral intravenous (IV), central IV, and intracoronary (IC) routes.
Methods
Prospective two-center pilot cohort study of acute myocardial infarction patients who suffered cardiac arrest in the cardiac catheterization laboratory during percutaneous coronary intervention. We compared the outcomes of patients who received epinephrine via peripheral IV, central IV, or IC.
Results
158 participants were enrolled, 48 (30.4%), 50 (31.6%), and 60 (38.0%) in the central IV, IC, and peripheral IV arms, respectively. Peripheral IV epinephrine administration route was associated with lower odds of achieving return of spontaneous circulation (ROSC, odds ratio = 0.14, 95% confidence interval = 0.05–0.36, p < 0.0001) compared with central IV and IC administration. (There was no difference between central IV and IC routes; p = 0.9343.) The odds of stent thrombosis were significantly higher with the IC route (IC vs. peripheral IV OR = 4.6, 95% CI = 1.5–14.3, p = 0.0094; IC vs. central IV OR = 6.0, 95% CI = 1.9–19.2, p = 0.0025). Post-ROSC neurologic outcomes were better for central IV and IC routes when compared with peripheral IV.
Conclusion
Epinephrine administration via central IV and IC routes was associated with a higher rate of ROSC and better neurologic outcomes compared with peripheral IV administration. IC administration was associated with a higher risk of stent thrombosis.
Trial registration This trial is registered at NCT05253937.
Graphical Abstract
Publisher
Springer Science and Business Media LLC
Subject
Critical Care and Intensive Care Medicine
Cited by
1 articles.
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