Cardiac arrest: no benefit of Amiodarone in survival to discharge or neurological outcomes


The 2015 Guidelines for Resuscitation recommend Amiodarone ( Cordarone ) as the antiarrhythmic drug of choice in the treatment of resistant ventricular fibrillation or pulseless ventricular tachycardia.

Researchers have reviewed the effects of Amiodarone on survival and neurological outcome after cardiac arrest.

Search initially identified 1663 studies, 1458 from MEDLINE and 205 from Cochrane Library. Of them, 4 randomized controlled studies and 6 observational studies met the inclusion criteria and were selected for further review.
Three randomized studies were included in the meta-analysis.

Amiodarone significantly improves survival to hospital admission ( OR=1.402, 95% CI: 1.068-1.840, Z=2.43, P=0.015 ), but neither survival to hospital discharge ( RR=0.850, 95% CI: 0.631-1.144, Z=1.07, P=0.284 ) nor neurological outcome compared to placebo or Nifekalant ( OR=1.114, 95% CI: 0.923-1.345, Z=1.12, P=0.475 ).

In conclusion, Amiodarone significantly improves survival to hospital admission. However there is no benefit of Amiodarone in survival to discharge or neurological outcomes compared to placebo or other antiarrhythmics. ( Xagena )

Laina A et al, Int J Cardiol 2016;221:780-788

XagenaMedicine_2016



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