The main drug used to resuscitate cardiac arrest victims has needlessly left thousands of people with brain damage, according to a major new trial.
Adrenaline, which paramedics inject when CPR (Cardiopulmonary resuscitation) and electric shocks are failing to work, barely improves the chances of living but nearly doubles serious neurological harm among those who do survive.
Scientists believe it may damage the function of blood vessels in the brain, leaving patients in a vegetative state.
Either that or adrenaline causes damage because the heart can survive without oxygen for longer than the brain, meaning that although it can be restarted the brain is likely to be permanently impaired.
The drug is given to around eight in ten of the 30,000 people who suffer a cardiac arrest - when the heart stops beating - outside hospital every year in the UK, of whom only 10 per cent survive.
The findings of the study by the University of Warwick means health leaders may ban ambulance crews from using it.
The authors said the results further highlighted the importance of CPR and defibrillation skills among the public.
Published in the New England Journal of Medicine, the study involved 8,000 patients across five ambulance areas in England between 2014 and 2017.
Paramedics attending a cardiac arrest victim administered either an adrenaline shot or a placebo injection.
Of the 128 patients who were given adrenaline and survived, 40 - 30.1 per cent - had severe brain damage, compared with 17 of the 91 survivors - 18.7 per cent - who were given a placebo.
Professor Gavin Perkins, an expert in critical care medicine at Warwick, said: “What we’ve shown is that adrenaline can restart the heart but it’s no good for the brain.”
Previous research indicates that for every minute a cardiac arrest victim goes without treatment, their chances of survival drop by 10 per cent.
Paramedics will typically make three attempts to restart the heart using a defibrillator before injecting adrenaline, a process that takes around six to eight minutes.
Professor Jerry Nolan, from the Royal United Hospital Bath, who co-authored the paper, said it “highlights the critical importance of the community respond to cardiac arrest”.
“Unlike adrenaline, members of the public can make a much bigger difference to survival through learning how to recognise cardiac arrest, perform CPR and deliver an electric shock with a defibrillator,” he said.
https://www.telegraph.co.uk/science/2018/07/18/cardiac-arrest-resuscitation-drug-has-needlessly-brain-damaged/
