Naloxone During Out-of-Hospital Cardiac Arrest Linked To Better Outcomes

Key Takeaways

• Naloxone administration during resuscitation was associated with higher survival to hospital discharge in suspected out-of-hospital cardiac arrest.
• Naloxone use was also associated with better neurologic outcomes and higher return of spontaneous circulation.

Among EMS-treated patients with suspected out-of-hospital cardiac arrest, survival to hospital discharge was 8.1% with naloxone and 4.4% without. The retrospective cohort study using California Resuscitation Outcomes Consortium data from 2021 to 2022 included out-of-hospital resuscitation cases from 3,811 patients during that period. Investigators assessed naloxone administration during resuscitation in suspected out-of-hospital cardiac arrest.

After accounting for patient and clinical factors, naloxone use was associated with a 2.8% absolute increase in survival. Investigators also reported a 3.2% improvement in neurologic outcomes and a 3.3% improvement in return of spontaneous circulation.

The association appeared stronger in patients with EMS-suspected drug-related cardiac arrest, where survival differences approached 8% to 9%. Investigators also observed a weaker association in some settings, especially among patients who required epinephrine during resuscitation.