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Drug use during adult advanced cardiac life support: An overview of reviews

AIM: To conduct an overview of systematic reviews and meta-analyses to summarize the ever-growing evidence on drug use during advanced life support. METHODS: We searched Embase, Medline, Cochrane central register of controlled trials and Web of science for systematic reviews and meta-analyses report...

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Autores principales: Vandersmissen, Hans, Gworek, Hanne, Dewolf, Philippe, Sabbe, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371248/
https://www.ncbi.nlm.nih.gov/pubmed/34430950
http://dx.doi.org/10.1016/j.resplu.2021.100156
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author Vandersmissen, Hans
Gworek, Hanne
Dewolf, Philippe
Sabbe, Marc
author_facet Vandersmissen, Hans
Gworek, Hanne
Dewolf, Philippe
Sabbe, Marc
author_sort Vandersmissen, Hans
collection PubMed
description AIM: To conduct an overview of systematic reviews and meta-analyses to summarize the ever-growing evidence on drug use during advanced life support. METHODS: We searched Embase, Medline, Cochrane central register of controlled trials and Web of science for systematic reviews and meta-analyses reporting on drug use during advanced life support from inception to March, 2020. Two reviewers independently assessed all abstracts for eligibility, extracted data and assessed risk of bias using the AMSTAR-2 tool. Corrected covered areas were calculated from publication citation matrices to account for potential risk of bias. Data were graphically represented using forest plots. RESULTS: Twenty-two head-to-head drug comparisons from 47 included articles were analysed. Adrenaline significantly increases the incidence of return of spontaneous circulation and survival to hospital discharge, but not the incidence of neurological intact survival. Vasopressin alone or in combination with adrenaline is not superior to adrenaline alone. There is a trend favouring lidocaine over amiodarone in shockable cardiac arrest. The risk of bias assessment of included studies ranged from very low to very high and the overlap between articles was moderate to high. CONCLUSIONS: In line with the guidelines, we currently suggest that a standard dose of adrenaline should be administered during resuscitation, however, studies assessing lower doses of adrenaline are pressing. There is no rationale for the combination of vasopressin and adrenaline or vasopressin alone instead of adrenaline. In addition, lidocaine is a valuable alternative for amiodarone and maybe even preferable for shockable cardiac arrest. However more research is necessary.
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spelling pubmed-83712482021-08-23 Drug use during adult advanced cardiac life support: An overview of reviews Vandersmissen, Hans Gworek, Hanne Dewolf, Philippe Sabbe, Marc Resusc Plus Review AIM: To conduct an overview of systematic reviews and meta-analyses to summarize the ever-growing evidence on drug use during advanced life support. METHODS: We searched Embase, Medline, Cochrane central register of controlled trials and Web of science for systematic reviews and meta-analyses reporting on drug use during advanced life support from inception to March, 2020. Two reviewers independently assessed all abstracts for eligibility, extracted data and assessed risk of bias using the AMSTAR-2 tool. Corrected covered areas were calculated from publication citation matrices to account for potential risk of bias. Data were graphically represented using forest plots. RESULTS: Twenty-two head-to-head drug comparisons from 47 included articles were analysed. Adrenaline significantly increases the incidence of return of spontaneous circulation and survival to hospital discharge, but not the incidence of neurological intact survival. Vasopressin alone or in combination with adrenaline is not superior to adrenaline alone. There is a trend favouring lidocaine over amiodarone in shockable cardiac arrest. The risk of bias assessment of included studies ranged from very low to very high and the overlap between articles was moderate to high. CONCLUSIONS: In line with the guidelines, we currently suggest that a standard dose of adrenaline should be administered during resuscitation, however, studies assessing lower doses of adrenaline are pressing. There is no rationale for the combination of vasopressin and adrenaline or vasopressin alone instead of adrenaline. In addition, lidocaine is a valuable alternative for amiodarone and maybe even preferable for shockable cardiac arrest. However more research is necessary. Elsevier 2021-08-13 /pmc/articles/PMC8371248/ /pubmed/34430950 http://dx.doi.org/10.1016/j.resplu.2021.100156 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review
Vandersmissen, Hans
Gworek, Hanne
Dewolf, Philippe
Sabbe, Marc
Drug use during adult advanced cardiac life support: An overview of reviews
title Drug use during adult advanced cardiac life support: An overview of reviews
title_full Drug use during adult advanced cardiac life support: An overview of reviews
title_fullStr Drug use during adult advanced cardiac life support: An overview of reviews
title_full_unstemmed Drug use during adult advanced cardiac life support: An overview of reviews
title_short Drug use during adult advanced cardiac life support: An overview of reviews
title_sort drug use during adult advanced cardiac life support: an overview of reviews
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371248/
https://www.ncbi.nlm.nih.gov/pubmed/34430950
http://dx.doi.org/10.1016/j.resplu.2021.100156
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