Amiodarone and cardiac arrest: Systematic review and meta-analysis

Abstract Introduction The 2015 Guidelines for Resuscitation recommend amiodarone as the antiarrhythmic drug of choice in the treatment of resistant ventricular fibrillation or pulseless ventricular tachycardia. We reviewed the effects of amiodarone on survival to hospital discharge and neurological...

Full description

Saved in:
Bibliographic Details
Published in:International journal of cardiology 2016-10, Vol.221, p.780-788
Main Authors: Laina, Ageliki, Karlis, George, Liakos, Aris, Georgiopoulos, Georgios, Oikonomou, Dimitrios, Kouskouni, Evangelia, Chalkias, Athanasios, Xanthos, Theodoros
Format: Article
Language:English
Subjects:
Amiodarone
Amiodarone - therapeutic use
Anti-Arrhythmia Agents - therapeutic use
Cardiac arrest
Cardiopulmonary resuscitation
Cardiovascular
Heart Arrest - diagnosis
Heart Arrest - drug therapy
Heart Arrest - mortality
Humans
Meta-analysis
Observational Studies as Topic - methods
Patient Admission - trends
Patient Discharge - trends
Randomized Controlled Trials as Topic - methods
Survival Rate - trends
Systematic review
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Introduction The 2015 Guidelines for Resuscitation recommend amiodarone as the antiarrhythmic drug of choice in the treatment of resistant ventricular fibrillation or pulseless ventricular tachycardia. We reviewed the effects of amiodarone on survival to hospital discharge and neurological outcome after cardiac arrest. Methods We systematically searched MEDLINE and Cochrane Library from 1940 to March 2016 without language restrictions. Randomized control trials (RCTs) and observational studies were selected. Results Our search initially identified 1628 studies, 1460 from MEDLINE and 168 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). Conclusions 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.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2016.07.138