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  1. NTU Scholars
  2. 醫學院
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Please use this identifier to cite or link to this item: https://scholars.lib.ntu.edu.tw/handle/123456789/392853
Title: Prehospital intravenous epinephrine may boost survival of patients with traumatic cardiac arrest: A retrospective cohort study
Authors: MATTHEW HUEI-MING MA
MING-JU HSIEH
CHIH-WEI YANG
WEN-CHU CHIANG
HUI-CHIH WANG
SHEY-YING CHEN
Issue Date: 2015
Journal Volume: 23
Journal Issue: 1
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 
Abstract: 
Background: Prehospital resuscitation for patients with major trauma emphasizes a load-and-go principle. For traumatic cardiac arrest (TCA) patients, the administration of vasopressors remains under debate. This study evaluated the effectiveness of epinephrine in the prehospital setting for patients with TCA. Methods: We conducted a retrospective cohort study using a prospectively collected registry for out-of-hospital cardiac arrest in Taipei. Enrollees were ?18 years of age with TCA. Patients with signs of obvious death like decapitation or rigor mortis were excluded. Patients were grouped according to prehospital administration, or lack thereof, of epinephrine. Outcomes were sustained (?2 h) recovery of spontaneous circulation (ROSC) and survival to discharge. A subgroup analysis was performed by stratified total prehospital time. Results: From June 1 2010 to May 31 2013, 514 cases were enrolled. Epinephrine was administered in 43 (8.4 %) cases. Among all patients, sustained ROSC and survival to discharge was 101 (19.6 %) and 20 (3.9 %), respectively. The epinephrine group versus the non-epinephrine group had higher sustained ROSC (41.9 % vs. 17.6 %, p < 0.01) and survival to discharge (14.0 % vs. 3.0 %, p < 0.01). The adjusted odds ratios (ORs) of epinephrine effect were 2.24 (95 % confidence interval (CI) 1.05-4.81) on sustained ROSC, and 2.94 (95 % CI 0.85-10.15) on survival to discharge. Subgroup analysis showed increased ORs of epinephrine effect on sustained ROSC with a longer prehospital time. Conclusion: Among adult patients with TCA in an Asian metropolitan area, administration of epinephrine in the prehospital setting was associated with increased short-term survival, especially for those with a longer prehospital time. ? 2015 Chiang et al.
URI: http://www.scopus.com/inward/record.url?eid=2-s2.0-84947941524&partnerID=MN8TOARS
http://scholars.lib.ntu.edu.tw/handle/123456789/392853
DOI: 10.1186/s13049-015-0181-4
metadata.dc.subject.other: epinephrine; vasoconstrictor agent; adult; aged; complication; dose response; emergency health service; epidemiology; female; follow up; human; injury; intravesical drug administration; male; middle aged; mortality; Out-of-Hospital Cardiac Arrest; procedures; register; resuscitation; retrospective study; survival rate; Taiwan; time factor; trends; Administration, Intravesical; Adult; Aged; Cardiopulmonary Resuscitation; Dose-Response Relationship, Drug; Emergency Medical Services; Epinephrine; Female; Follow-Up Studies; Humans; Male; Middle Aged; Out-of-Hospital Cardiac Arrest; Registries; Retrospective Studies; Survival Rate; Taiwan; Time Factors; Vasoconstrictor Agents; Wounds and Injuries
[SDGs]SDG3
Appears in Collections:醫學系

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臺大位居世界頂尖大學之列,為永久珍藏及向國際展現本校豐碩的研究成果及學術能量,圖書館整合機構典藏(NTUR)與學術庫(AH)不同功能平台,成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。

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