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Effectiveness of antiarrhythmic drugs for shockable cardiac arrest : a systematic review
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Ali, Muhammad Usman, Fitzpatrick-Lewis, Donna, Kenny, Meghan, Raina, Parminder, Atkins, Dianne L., Soar, Jasmeet, Nolan, Jerry P., Ristagno, Giuseppe and Sherifali, Diana (2018) Effectiveness of antiarrhythmic drugs for shockable cardiac arrest : a systematic review. Resuscitation, 132 . pp. 63-72. doi:10.1016/j.resuscitation.2018.08.025
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Official URL: http://dx.doi.org/10.1016/j.resuscitation.2018.08....
Abstract
Purpose
The purpose of this systematic review is to provide up-to-date evidence on effectiveness of antiarrhythmic drugs for shockable cardiac arrest to help inform the 2018 International Liaison Committee on Resuscitation Consensus on Science with Treatment Recommendations.
Methods
A search was conducted in electronic databases Medline, Embase, and Cochrane Library from inception to August 15, 2017.
Results
Of the 9371 citations reviewed, a total of 14 RCTs and 17 observational studies met our inclusion criteria for adult population and only 1 observational study for pediatric population. Based on RCT level evidence for adult population, none of the anti-arrhythmic drugs showed any difference in effect compared with placebo, or with other anti-arrhythmic drugs for the critical outcomes of survival to hospital discharge and discharge with good neurological function. For the outcome of return of spontaneous circulation, the results showed a significant increase for lidocaine compared with placebo (RR = 1.16; 95% CI, 1.03–1.29, p = 0.01).
Conclusion
The high level evidence supporting the use of antiarrhythmic drugs during CPR for shockable cardiac arrest is limited and showed no benefit for critical outcomes of survival at hospital discharge, survival with favorable neurological function and long-term survival. Future high quality research is needed to confirm these findings and also to evaluate the role of administering antiarrhythmic drugs in children with shockable cardiac arrest, and in adults immediately after ROSC.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Cardiac arrest -- Treatment, Myocardial depressants | ||||||||
| Journal or Publication Title: | Resuscitation | ||||||||
| Publisher: | Elsevier Ireland Ltd | ||||||||
| ISSN: | 0300-9572 | ||||||||
| Official Date: | November 2018 | ||||||||
| Dates: |
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| Date of first compliant deposit: | 5 February 2019 | ||||||||
| Volume: | 132 | ||||||||
| Page Range: | pp. 63-72 | ||||||||
| DOI: | 10.1016/j.resuscitation.2018.08.025 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| RIOXX Funder/Project Grant: |
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