Scientists from the Parisian Cardiovascular Research Center in France found the administration of epinephrine after someone suffers a heart attack may increase the likelihood of death or brain damage.
Epinephrine is a hormone that promotes blood flow, and is often given to patients who have gone into cardiac arrest and need their hearts restarted, HealthDay reported. It has been proven to be effective when electricity from a defibrillator is not effective. However, the scientists' newest findings found the effective drug can have dangerous side effects and called into questions its popularity.
"The role of epinephrine is more and more questionable in cardiac arrest," Healthday reported lead author Dr. Florence Dumas, of the Parisian Cardiovascular Research Center in France, said in the release. "We need to constantly assess our procedures and protocols to make sure that the use of epinephrine is effective and done at the correct time."
Epinephrine associated with fewer good outcomes
The researchers reviewed the records of more than 1,500 people who were admitted to a large hospital in Paris between January 2000 and August 2012, according to a press release from the American College of Cardiology, which published the study. All the patients experienced a heart attack outside of the hospital but were resuscitated through medical treatment.
Seventy-three percent of the patients received some dosage of epinephrine, and of these patients, 17 percent experienced a beneficial outcome, which was measured by being discharged with normal or only a small level of compromised brain function. Of the patients who did not receive epinephrine, 63 percent had a beneficial outcome.
The researchers also found patients who were given a higher dose of epinephrine had worse outcomes compared to those given lower doses of the drug. Patients who received 5-milligram doses were 77 percent more likely to have a bad outcome, such as death or brain damage, compared to patients not given epinephrine and patients given 1-mg doses were 52 percent more likely to have a negative outcome compared to nontreated patients.
Current best practices recommend physicians provide 1-mg doses every three to five minutes while attempting to revive a patient, and the researchers are not ready to suggest that this standard changes, according to the ACC's release. The authors of the study recognize epinephrine has been proven to help many patients, and in low doses can do so effectively and with minimal risk of death or brain damage. Instead, they believe this study proves two things: Physicians must be cautious when using epinephrine, and more research should be conducted to determine when it becomes unsafe for patients.
"It would be dangerous to completely incriminate this drug, because it may well be helpful for certain patients under certain circumstances," said Dumas in the ACC's release. "This is one more study that points strongly to the need to study epinephrine further in animals and in randomized trials."