Highlights
- •Amiodarone significantly improves survival to hospital admission.
- •Amiodarone does not improve survival to hospital discharge.
- •Amiodarone does not improve neurological outcome.
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 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 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).
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.
Keywords
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Article info
Publication history
Published online: July 09, 2016
Accepted:
July 8,
2016
Received:
May 21,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
