Adrenaline to improve survival in out-of-hospital cardiac arrest: the PARAMEDIC2 RCT.
Perkins GD., Ji C., Achana F., Black JJ., Charlton K., Crawford J., de Paeztron A., Deakin C., Docherty M., Finn J., Fothergill RT., Gates S., Gunson I., Han K., Hennings S., Horton J., Khan K., Lamb S., Long J., Miller J., Moore F., Nolan J., O'Shea L., Petrou S., Pocock H., Quinn T., Rees N., Regan S., Rosser A., Scomparin C., Slowther A., Lall R.
BACKGROUND: Adrenaline has been used as a treatment for cardiac arrest for many years, despite uncertainty about its effects on long-term outcomes and concerns that it may cause worse neurological outcomes. OBJECTIVES: The objectives were to evaluate the effects of adrenaline on survival and neurological outcomes, and to assess the cost-effectiveness of adrenaline use. DESIGN: This was a pragmatic, randomised, allocation-concealed, placebo-controlled, parallel-group superiority trial and economic evaluation. Costs are expressed in Great British pounds and reported in 2016/17 prices. SETTING: This trial was set in five NHS ambulance services in England and Wales. PARTICIPANTS: Adults treated for an out-of-hospital cardiac arrest were included. Patients were ineligible if they were pregnant, if they were aged