Adrenaline dosage during cardiopulmonary resuscitation: a critical review

Since the end of the nineteenth century adrenaline has been used for the treatment of cardiac arrest. Since the 1960s a standard 1 mg dose administered intravenously every 5 min is common practice in cardiopulmonary resuscitation. Because of growing interest in the pharmacological aspects of cardiopulmonary resuscitation, experimental studies in animals conducted in the 1980s suggested the use of higher doses of adrenaline. Several case reports of successfully resuscitated patients who had been given high dose adrenaline were published, but large, prospective, randomized, controlled clinical trials in humans found no statistically significant improvement in survival rates between high dose and standard dose resuscitated patients. It seems that 1 mg adrenaline given intravenously every 3-5 min during resuscitation for cardiac arrest remains the standard.