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Review
. 2024 Mar 12;16(3):e56037.
doi: 10.7759/cureus.56037. eCollection 2024 Mar.

Comparison of the Effects of Lidocaine and Amiodarone on Patients With Cardiac Arrest: A Systematic Review and Meta-Analysis

Tanya Sinha  1 , Ibrahim Reyaz  2 , Roba A Ibrahim  3 , Manisha Guntha  4 , Aung K Zin  5 , Grahitha Chapala  6 , Mohan K Ravuri  6 , Sujith K Palleti  7
Affiliations
Review

Comparison of the Effects of Lidocaine and Amiodarone on Patients With Cardiac Arrest: A Systematic Review and Meta-Analysis

Tanya Sinha et al. Cureus. .

Abstract

The objective of this study was to compare the impact of amiodarone and lidocaine on survival and neurological outcomes following cardiac arrest. A systematic review of randomized controlled trials (RCTs) as well as cohort and cross-sectional trials was undertaken, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Potential relevant studies were searched in databases, including PubMed, Embase, Cochrane Library, and Web of Science, from the beginning of databases to February 15, 2024. Outcomes assessed in this study were survival to hospital discharge, survival to hospital admission or 24 hours, favorable neurological outcomes, and return of spontaneous circulation (ROSC). A total of seven studies (five observational and two RCTs) were included in this meta-analysis encompassing 19,081 patients with cardiac arrest. Pooled analysis showed no difference between amiodarone and lidocaine in terms of survival to hospital discharge (odds ratio (OR): 0.88, 95% confidence interval (CI): 0.75 to 1.04), ROSC (OR: 0.94, 95% CI: 0.84 to 1.05, p-value: 0.25), favorable neurological outcomes (OR: 0.88, 95% CI: 0.66 to 1.17, p-value: 0.38), and survival to 24 hours (OR: 0.82, 95% CI: 0.55 to 1.21, p-value: 0.31). While lidocaine demonstrated a slight survival advantage, the differences were statistically insignificant. Similarly, no significant variations were observed in ROSC incidence, neurological outcomes, or survival at 24 hours. These findings align with current guidelines but underscore the necessity for further rigorous RCTs to provide conclusive recommendations.

Keywords: amiodarone; cardiac arrest; lidocaine; meta-analysis; mortality.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flowchart of study selection
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2. Forest plot comparing survival to hospital discharge between two groups
Sources: [13,15-19].
Figure 3
Figure 3. Forest plot comparing the return of spontaneous circulation (ROSC) between two groups
Sources: [13,15,18,19].
Figure 4
Figure 4. Forest plot comparing favorable neurological outcomes between study groups
Sources: [14,15,18,19].
Figure 5
Figure 5. Forest plot comparing survival to 24 hours between study groups
Sources: [16,18,19].
See this image and copyright information in PMC

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References

    1. The incidence, predictors, and causes of cardiac arrest in United States emergency departments. Hsu SH, Sung CW, Lu TC, et al. Resusc Plus. 2024;17:100514. - PMC - PubMed
    1. Outcomes of in-hospital cardiac arrest: a review of the evidence. DiLibero J, Misto K. Crit Care Nurs Clin North Am. 2021;33:343–356. - PubMed
    1. The role of inflammatory cytokines in cardiac arrest. Jou C, Shah R, Figueroa A, Patel JK. J Intensive Care Med. 2020;35:219–224. - PubMed
    1. The immunology of the post-cardiac arrest syndrome. Cunningham CA, Coppler PJ, Skolnik AB. Resuscitation. 2022;179:116–123. - PubMed
    1. Cardiac arrest caused by anaphylaxis refractory to prompt management. Park H, Kim SM, Kim WY. Am J Emerg Med. 2022;61:74–80. - PubMed

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