Amiodarone or lidocaine for cardiac arrest: A systematic review and meta-analysis

Filippo Sanfilippo, C. Corredor, Cristina Santonocito, Giovanna Panarello, Antonio Filippo Arcadipane, Giuseppe Ristagno, Tommaso Pellis

Research output: Contribution to journalReview article

Abstract

Background Guidelines for treatment of out-of-hospital cardiac arrest (OOH-CA) with shockable rhythm recommend amiodarone, while lidocaine may be used if amiodarone is not available. Recent underpowered evidence suggests that amiodarone, lidocaine or placebo are equivalent with respect to survival at hospital discharge, but amiodarone and lidocaine showed higher hospital admission rates. We undertook a systematic review and meta-analysis to assess efficacy of amiodarone vs lidocaine vs placebo. Methods We included studies published in PubMed and EMBASE databases from inception until May 15th, 2016. The primary outcomes were survival at hospital admission and discharge in OOH-CA patients enrolled in randomized clinical trials (RCT) according to resuscitation with amiodarone vs lidocaine vs placebo. If feasible, secondary analysis was performed including in the analysis also patients with in-hospital CA and data from non-RCT. Results A total of seven findings were included in the metanalysis (three RCTs, 4 non-RCTs). Amiodarone was as beneficial as lidocaine for survival at hospital admission (primary analysis odds ratio—OR 0.86–1.23, p = 0.40) and discharge (primary analysis OR 0.87–1.30, p = 0.56; secondary analysis OR 0.86–1.27, p = 0.67). As compared with placebo, survival at hospital admission was higher both for amiodarone (primary analysis OR 1.12–1.54, p

Original languageEnglish
Pages (from-to)31-37
Number of pages7
JournalResuscitation
Volume107
DOIs
Publication statusPublished - Oct 1 2016

Keywords

  • Hospital admission
  • Hospital discharge
  • Out-of-hospital cardiac arrest
  • Placebo
  • Return of spontaneous circulation

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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