Is epinephrine still the drug of choice during cardiac arrest in the emergency department of the hospital? A meta-analysis
Epinephrine is the first-line emergency drug for cardiac arrest and anaphylactic reactions but is reported to be associated with many challenges resulting in its under- or improper utilization. Therefore, in this meta-analysis, the efficacy and safety of epinephrine as a first-line cardiac emergency...
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Sciendo
2023-09-01
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| Series: | Acta Pharmaceutica |
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| Online Access: | https://doi.org/10.2478/acph-2023-0022 |
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| _version_ | 1832557801465970688 |
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| author | Hou Min Dong Su Kan Qing Ouyang Meng Zhang Yun |
| author_facet | Hou Min Dong Su Kan Qing Ouyang Meng Zhang Yun |
| author_sort | Hou Min |
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| description | Epinephrine is the first-line emergency drug for cardiac arrest and anaphylactic reactions but is reported to be associated with many challenges resulting in its under- or improper utilization. Therefore, in this meta-analysis, the efficacy and safety of epinephrine as a first-line cardiac emergency drug for both out-of-hospital and in-hospital patients was assessed. Pertinent articles were searched in central databases like PubMed, Scopus, and Web of Science, using appropriate keywords as per the PRISMA guidelines. Retrospective and prospective studies were included according to the predefined PICOS criteria. RevMan and MedCalc software were used and statistical parameters such as odds ratio and risk ratio were calculated. Twelve clinical trials with a total of 208,690 cardiac arrest patients from 2000 to 2022 were included, in accordance with the chosen inclusion criteria. In the present meta-analysis, a high odds ratio (OR) value of 3.67 (95 % CI 2.32–5.81) with a tau2 value of 0.64, a chi2 value of 12,446.86, df value of 11, I2 value of 100 %, Z-value 5.53, and a p-value < 0.00001 were reported. Similarly, the risk ratio of 1.89 (95 % CI 1.47–2.43) with a tau2 value of 0.19, chi2 value of 11,530.67, df value of 11, I2 value of 100 %, Z-value of 4.95, and p-value < 0.000001. The present meta-analysis strongly prefers epinephrine injection as the first cardiac emergency drug for both out-of-hospital and in-hospital patients during cardiac arrest. |
| format | Article |
| id | doaj-art-ec85c34bb1d44f2493b7172fba37a457 |
| institution | Kabale University |
| issn | 1846-9558 |
| language | English |
| publishDate | 2023-09-01 |
| publisher | Sciendo |
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| series | Acta Pharmaceutica |
| spelling | doaj-art-ec85c34bb1d44f2493b7172fba37a4572025-02-03T02:26:14ZengSciendoActa Pharmaceutica1846-95582023-09-0173332533910.2478/acph-2023-0022Is epinephrine still the drug of choice during cardiac arrest in the emergency department of the hospital? A meta-analysisHou Min0Dong Su1Kan Qing2Ouyang Meng3Zhang Yun4Department of Cardiovascular Internal Medicine, People’s Hospital of Dongxihu District, Wuhan, Wuhan City, Hubei Province, 430040, ChinaDepartment of Pharmacy, People’s Hospital of Dongxihu District, Wuhan Wuhan City, Hubei Province, 430040ChinaDepartment of Pharmacy, Hankou Hospital of Wuhan, Wuhan City, Hubei Province, 430040, ChinaDepartment of Pharmacy, The First People’s Hospital of Jiang Xia District Wuhan City, Hubei Province, 430000ChinaDepartment of Pharmacy, The First People’s Hospital of Jiang Xia District Wuhan City, Hubei Province, 430000ChinaEpinephrine is the first-line emergency drug for cardiac arrest and anaphylactic reactions but is reported to be associated with many challenges resulting in its under- or improper utilization. Therefore, in this meta-analysis, the efficacy and safety of epinephrine as a first-line cardiac emergency drug for both out-of-hospital and in-hospital patients was assessed. Pertinent articles were searched in central databases like PubMed, Scopus, and Web of Science, using appropriate keywords as per the PRISMA guidelines. Retrospective and prospective studies were included according to the predefined PICOS criteria. RevMan and MedCalc software were used and statistical parameters such as odds ratio and risk ratio were calculated. Twelve clinical trials with a total of 208,690 cardiac arrest patients from 2000 to 2022 were included, in accordance with the chosen inclusion criteria. In the present meta-analysis, a high odds ratio (OR) value of 3.67 (95 % CI 2.32–5.81) with a tau2 value of 0.64, a chi2 value of 12,446.86, df value of 11, I2 value of 100 %, Z-value 5.53, and a p-value < 0.00001 were reported. Similarly, the risk ratio of 1.89 (95 % CI 1.47–2.43) with a tau2 value of 0.19, chi2 value of 11,530.67, df value of 11, I2 value of 100 %, Z-value of 4.95, and p-value < 0.000001. The present meta-analysis strongly prefers epinephrine injection as the first cardiac emergency drug for both out-of-hospital and in-hospital patients during cardiac arrest.https://doi.org/10.2478/acph-2023-0022cardiac arrestepinephrine/adrenalinecardio-pulmonary resuscitationcardiac-emergency medicineintravenous injectionintracardiac injection |
| spellingShingle | Hou Min Dong Su Kan Qing Ouyang Meng Zhang Yun Is epinephrine still the drug of choice during cardiac arrest in the emergency department of the hospital? A meta-analysis Acta Pharmaceutica cardiac arrest epinephrine/adrenaline cardio-pulmonary resuscitation cardiac-emergency medicine intravenous injection intracardiac injection |
| title | Is epinephrine still the drug of choice during cardiac arrest in the emergency department of the hospital? A meta-analysis |
| title_full | Is epinephrine still the drug of choice during cardiac arrest in the emergency department of the hospital? A meta-analysis |
| title_fullStr | Is epinephrine still the drug of choice during cardiac arrest in the emergency department of the hospital? A meta-analysis |
| title_full_unstemmed | Is epinephrine still the drug of choice during cardiac arrest in the emergency department of the hospital? A meta-analysis |
| title_short | Is epinephrine still the drug of choice during cardiac arrest in the emergency department of the hospital? A meta-analysis |
| title_sort | is epinephrine still the drug of choice during cardiac arrest in the emergency department of the hospital a meta analysis |
| topic | cardiac arrest epinephrine/adrenaline cardio-pulmonary resuscitation cardiac-emergency medicine intravenous injection intracardiac injection |
| url | https://doi.org/10.2478/acph-2023-0022 |
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