Epinephrine in cardiac arrest: systematic review and meta-analysis.

Epinephrine in cardiac arrest: systematic review and meta-analysis.
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DOI:
10.1590/1518-8345.1317.2821
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发表时间:
2016-12-08
影响因子:
1.8
通讯作者:
Rodríguez-Borrego MA
Rodríguez-Borrego MA
中科院分区:
医学4区
文献类型:
--
作者:
Morales-Cané I;Valverde-León MD;Rodríguez-Borrego MA

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评估在心脏骤停期间使用肾上腺素的有效性及其对存活率和神经状况的影响。 使用随机效应模型,对科学文献进行荟萃分析的系统性综述。以下数据库用于研究临床试验和观察性研究:Medline、Embase和科克伦,2005年至2015年。 当将给予肾上腺素的自主循环恢复(ROSC)与不给予肾上腺素的ROSC进行比较时,发现给予肾上腺素的速率增加(OR 2.02,95% CI 1.49至2.75; I2 = 95%)。荟萃分析显示,肾上腺素给药后至出院或30天的生存率增加(OR 1.23; 95% IC 1.05-1.44; I2=83%)。按可电击和不可电击心律分层显示,不可电击心律的生存率增加(OR 1.52; 95%IC 1.29-1.78; I2=42%)。与延迟给药相比,在10分钟内给予肾上腺素显示存活率增加(OR 2.03; 95%IC 1.77-2.32; I2=0%)。 给予肾上腺素似乎增加了ROSC的发生率,但与其他疗法相比,对神经系统状态良好的患者的生存率没有发现积极的影响。
evaluate the effectiveness of epinephrine used during cardiac arrest and its effect on the survival rates and neurological condition. systematic review of scientific literature with meta-analysis, using a random effects model. The following databases were used to research clinical trials and observational studies: Medline, Embase and Cochrane, from 2005 to 2015. when the Return of Spontaneous Circulation (ROSC) with administration of epinephrine was compared with ROSC without administration, increased rates were found with administration (OR 2.02. 95% CI 1.49 to 2.75; I2 = 95%). Meta-analysis showed an increase in survival to discharge or 30 days after administration of epinephrine (OR 1.23; 95% IC 1.05-1.44; I2=83%). Stratification by shockable and non-shockable rhythms showed an increase in survival for non-shockable rhythm (OR 1.52; 95% IC 1.29-1.78; I2=42%). When compared with delayed administration, the administration of epinephrine within 10 minutes showed an increased survival rate (OR 2.03; 95% IC 1.77-2.32; I2=0%). administration of epinephrine appears to increase the rate of ROSC, but when compared with other therapies, no positive effect was found on survival rates of patients with favorable neurological status.
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