open access

Vol 78, No 10 (2020)
Original article
Published online: 2020-07-06
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Effect of amiodarone and lidocaine on shock-refractory cardiac arrest: a systematic review and meta-analysis

Kobi Ludwin, Jacek Smereka, Klaudiusz Nadolny, Jerzy R. Ładny, Agnieszka Szarpak, Zuzanna Fajfer, Miłosz Jaguszewski, Krzysztof J. Filipiak, Łukasz Szarpak
DOI: 10.33963/KP.15483
·
Pubmed: 32627999
·
Kardiol Pol 2020;78(10):999-1007.

open access

Vol 78, No 10 (2020)
Original article
Published online: 2020-07-06

Abstract

Background: Appropriate pharmacotherapy during advanced resuscitation procedures may affect the return of spontaneous circulation. Current guidelines on cardiopulmonary resuscitation recommend amiodarone for shock‑refractory cardiac arrest or when lidocaine is not available.

Aims: The aim of this study was to systematically analyze the available literature and to conduct a meta‑‑analysis to determine the effect of amiodarone and lidocaine on survival and neurological outcome after shock‑refractory cardiac arrest.

Methods: PubMed, Scopus, Embase, Web of Science, and Cochrane Library databases were searched. Two independent reviewers screened randomized and quasi‑randomized controlled trials as well as cohort and cross‑sectional trials evaluating amiodarone or lidocaine for the treatment of adults with cardiac arrest.

Results: After screening 682 unique references, 8 were selected for this meta‑analysis. A higher number of cases with return of spontaneous circulation was observed in the amiodarone group compared with the lidocaine group (OR, 1.03; 95% CI, 0.87–1.21; P = 0.75). A similar relationship was observed for survival to hospital discharge (OR, 1.12; 95% CI, 0.92–1.38; P = 0.26), as well as survival with favorable neurological outcome (OR, 1.11; 95% CI, 0.89–1.39; P = 0.35).

Conclusions: We found no statistically significant survival benefit of resuscitation with amiodarone compared with lidocaine. Future randomized controlled trials are needed to identify which antiarrhythmic drug should be use in shock‑refractory cardiac arrest.

Abstract

Background: Appropriate pharmacotherapy during advanced resuscitation procedures may affect the return of spontaneous circulation. Current guidelines on cardiopulmonary resuscitation recommend amiodarone for shock‑refractory cardiac arrest or when lidocaine is not available.

Aims: The aim of this study was to systematically analyze the available literature and to conduct a meta‑‑analysis to determine the effect of amiodarone and lidocaine on survival and neurological outcome after shock‑refractory cardiac arrest.

Methods: PubMed, Scopus, Embase, Web of Science, and Cochrane Library databases were searched. Two independent reviewers screened randomized and quasi‑randomized controlled trials as well as cohort and cross‑sectional trials evaluating amiodarone or lidocaine for the treatment of adults with cardiac arrest.

Results: After screening 682 unique references, 8 were selected for this meta‑analysis. A higher number of cases with return of spontaneous circulation was observed in the amiodarone group compared with the lidocaine group (OR, 1.03; 95% CI, 0.87–1.21; P = 0.75). A similar relationship was observed for survival to hospital discharge (OR, 1.12; 95% CI, 0.92–1.38; P = 0.26), as well as survival with favorable neurological outcome (OR, 1.11; 95% CI, 0.89–1.39; P = 0.35).

Conclusions: We found no statistically significant survival benefit of resuscitation with amiodarone compared with lidocaine. Future randomized controlled trials are needed to identify which antiarrhythmic drug should be use in shock‑refractory cardiac arrest.

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About this article
Title

Effect of amiodarone and lidocaine on shock-refractory cardiac arrest: a systematic review and meta-analysis

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 78, No 10 (2020)

Article type

Original article

Pages

999-1007

Published online

2020-07-06

Page views

506

Article views/downloads

543

DOI

10.33963/KP.15483

Pubmed

32627999

Bibliographic record

Kardiol Pol 2020;78(10):999-1007.

Authors

Kobi Ludwin
Jacek Smereka
Klaudiusz Nadolny
Jerzy R. Ładny
Agnieszka Szarpak
Zuzanna Fajfer
Miłosz Jaguszewski
Krzysztof J. Filipiak
Łukasz Szarpak

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