treating cardiogenic shock use epinephrine carefully as may enhance mortality

Treating cardiogenic shock use epinephrine carefully as may enhance mortalityprof .DRRAM,HIV /AIDS,HEPATITIS ,SEX DISEASES & WEAKNESS expert,New Delhi,India, profdrram@gmail.com,+917838059592,+919832025033,ON WHATSAPP

Epinephrine or Adrenaline is widely used to increase blood pressure and treat cardiogenic shock resulting from acute myocardial infarction or other diseases but a recent study has shown that Epinephrine cause more mortality due to its bad effect on heart.

Among all-cause cardiogenic shock patients, treatment with epinephrine was associated with a much higher risk for death.
Results agree with forthcoming OptimaCC trial(included in this analysis), according to authors.
Authors: result “supports the need to reconsider the use of epinephrine in future guidelines.”

Key results

462 (18%) patients had been resuscitated after cardiac arrest.
Mortality with epinephrine vs other regimen:All cohorts: OR, 3.3 (95% CI, 2.8-3.9);
Subgroup risk-adjusted for age, sex, ischemic heart disease, renal function, and ejection fraction (n=1227): OR, 4.7 (95% CI, 3.4-6.4);
338 propensity-matched pairs: OR, 4.2 (95% CI, 3.0-6.0);
After exclusion of largest cohort: OR, 2.3 (95% CI, 1.9-2.8).
Only subgroup to benefit was one benefiting from extracorporeal life support (ECLS): 28% without ECLS vs 48% with ECLS (P<.0001).
Study design

Meta-analysis, individual patient data from 16 cohorts (n=2583).
Studies concerned patients in nonpostoperative cardiogenic shock treated with epinephrine vs other catecholamines.