Studying The Influence of Epinephrine Mixed With Prednisolone on The Neurologic Side Effects After Recovery in Patients Suffering From Cardiopulmonary Arrest

Ehsan bolvardi¹ , Esmat Seyedi² , Mohamad Seyedi³ , Amir Ajilian Abbasi² , Reza Golmakani² , Koorosh Ahmadi⁴

¹Emergecy Medicine Specialist, Mashhad University of Medical Sciences, Mashhad,Iran. ²Emergency Medicine Resident, Mashhad University of Medical Sciences, Mashhad, Iran. ³Instructor Department Of Educational Sciences Farhangian University, Mashhad, Iran. ⁴Department of Emergecy Medicine , Alborz University of Medical Sciences, Karaj, Iran. Corresponding Author Email : kooroshem@gmail.com

Abstract: Earlyneuro-cognitive disorders usually take place after cardiopulmonary arrest. As the previous studies indicate, this disorder is observed among 30 to 60 percent of the patients which can damage the memory or the psychomotor performance, impair post-cardiopulmonary arrest recovery, reduce life quality and delay return to work. The present study seeks to propose a method to reduce the neurologic side effects after CPR. In this research, we studied the clinical trials of 50 patients past 18 years who required cardiopulmonary resuscitation. The patients were divided into 2 groups. Intervention group was given an IV injection of 125 mg Methylprednisolone beside epinephrine. The placebo group was injected with saline as placebo. During the first 24 hours after resuscitation, the neurologic side effects of the patients was measured and analyzed using CPC score. The average age of the patients participating in this study was 68.92 years old. 33 patients (66 percent) were male, while 17 (34 percent) were female. The initial rhythm of resuscitation was VT in 14 patients, while this rhythm was Asystole in 36 patients. The CPR was successful for 9 patients in E+M group and for 6 patients in E group. Among the 9 patients in E+M group, 4 survived up to 24 hours. One patient had a CPC score of 1, two had a CPC score of 4, and one had a CPC score of 5. Of the six patients in group E, just 3 of them survived for 24 hours among whom one had a CPC score of 4 and two had a CPC score of 5. The comparisons made between the two groups in terms of percentage of successful CPR (P=0.269) and CPC score of the patients (P=0.329) revealed no significant difference. Utilizing Methylprednisolone had no significant influence on raising the level of ROSC or on attenuation of neurologic side effects in resuscitated patients suffering from cardiac arrest.

Keywords: cardiac arrest; neurologic side effects; epinephrine; prednisone; return of spontaneous circulation (ROSC)

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