This increases the chance of patients regaining their pulse after cardiac arrest fivefold

When a patient’s heart stops in a hospital, healthcare professionals need to act quickly.

“They immediately start cardiopulmonary resuscitation with breathing and chest compression, and connect to a defibrillator,” says Eirik Skogvoll.

He is a senior consultant at the Department of Anaesthesia and Intensive Care Medicine at St. Olavs Hospital.

But this is not always enough.

“If this does not get the heart going, we give the patient adrenaline intravenously,” he says.

First study of the use of adrenaline in hospitals

The fact that adrenaline also works to get the heart going in the event of cardiac arrest has long been a kind of accepted truth among healthcare workers.

Many people are familiar with adrenaline from its use in treating anaphylactic shock, a severe allergic reaction that can be deadly. It has been used in this context to resuscitate patients for more than 50 years.

Adrenaline is also well documented as useful in ambulances, outside hospitals. But the extent to which adrenaline works during cardiac arrest inside hospitals has not been directly investigated. Until now.

“The effect of adrenaline in this situation has so far not been unambiguously documented,” says Skogvoll, who is also a professor at NTNU's Department of Circulation and Medical Imaging.

But in a new study from St. Olavs Hospital and NTNU, anaesthesiologist Anders Norvik and the hospital’s emergency team have shown how effective adrenaline actually is, even with relatively few patients.

Adrenaline works almost immediately

“We found that adrenaline works within one minute. This increases the chance of the patient regaining their pulse fivefold,” says Norvik.

This is the first step for the patient to survive.

In other words, these are very convincing results.

The reason this research group can finally prove what many have believed is that healthcare workers recorded the exact time adrenaline was used during the resuscitation attempts. 

Further statistical analysis could therefore distinguish opinion from knowledge.

The first dose is what counts

But there is also a limit to how useful adrenaline is.

“If the patient does not respond to the first dose, it’s not very useful to give more doses,” says Norvik.

However, according to the anesthesiologist, this result is less certain.

Nevertheless, the first dose of adrenaline is the one that works best.

Reference:

Norvik et al. Adrenaline and return of spontaneous circulation during in-hospital cardiac arrest, Resuscitation Plus, 2025. DOI: 10.1016/j.resplu.2025.101140

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Read the Norwegian version of this article on forskning.no

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