2015 Evidence Summary
A number of trials have compared outcomes from standard-dose epinephrine with those of high-dose epinephrine. These trials did not demonstrate any benefit for high-dose epinephrine over stan- dard-dose epinephrine for survival to discharge with a good neu- rologic recovery (ie, Cerebral Performance Category score),116,117 survival to discharge,116–120 or survival to hospital admission.116–118,121
There was, however, a demonstrated ROSC advantage with high- dose epinephrine.116–121
2015 Recommendation—New
High-dose epinephrine is not recommended for routine use in cardiac arrest (Class III: No Benefit, LOE B-R).
Vasopressors in Cardiac Arrest: Epinephrine Versus
VasopressinALS 659
Vasopressin is a nonadrenergic peripheral vasoconstrictor that also causes coronary122,123 and renal vasoconstriction.124