High-Dose Epinephrine in Cardiopulmonary Resuscitation

To the Editor: The recent reports by Stiell¹ and Brown² and their colleagues (Oct. 8 issue) on the use of high-dose epinephrine for cardiac arrest in adults show an apparent lack of benefit. Stiell et al. found that some patients receiving high doses of epinephrine had a worse outcome, although Brown et al. found no adverse effects. These studies have as a theoretical basis studies in laboratory animals that had improved myocardial and cerebral blood flow when given epinephrine after cardiac arrest. However, other vascular beds, such as those of the mesentery and kidneys, are prone to the development of…