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Updated: Mar 10, 2026

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Published on: April 26, 2015
Epinephrine in cardiac arrest: systematic review and meta-analysis
Ignacio Morales-Cané1, María Del Rocío Valverde-León2, María Aurora Rodríguez-Borrego3
1Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. Universidad de Córdoba, Córdoba, Spain.
Objective:
evaluate the effectiveness of epinephrine used during cardiac arrest and its effect on the survival rates and neurological condition.
Method:
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.
Results:
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%).
Conclusion:
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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