ArticleResuscitation2026
Naloxone administration associated with improved survival in PEA out-of-hospital cardiac arrests.
Article in Resuscitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California.JAMA network open · 2024Article
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7 authors.
Funding
Abstract
introductionThe prevalence of opioid-associated out-of-hospital cardiac arrest (OA-OHCA) is increasing in the United States. Naloxone administration during OA-OHCA has been associated with improved clinical outcomes, but identifying OA-OHCA in the field remains challenging. Previous work demonstrated association between non-shockable cardiac rhythms and OA-OHCA, suggesting that cardiac rhythm may help identify patients likely to benefit from naloxone. In this work, we assessed the association of naloxone with clinical outcomes for patients with OHCA, stratifying by presenting cardiac rhythm.
methodsWe used 2019-2020 data from the ESO Data Collaborative in this retrospective cohort study. Cases were classified a priori according to presenting rhythm (shockable rhythm, pulseless electrical activity [PEA], asystole). The exposure was prehospital naloxone administration and outcomes of interest were prehospital ROSC and survival to hospital discharge. We utilized logistic regression and adjusted propensity-score matching to determine associations with outcomes.
resultsWe analyzed 40,333 cases in which 7567 (18.8%) patients received naloxone. Before matching, the rate of prehospital ROSC was 21.5% and survival to hospital discharge was 9.0%. After propensity score matching, patients in PEA who received naloxone had similar rates of ROSC (OR 1.09, 95%CI 0.90-1.31) and higher survival (OR 1.46, 95%CI 1.11-1.92). Naloxone administration was not associated with differences in either outcome in patients presenting with shockable rhythms or asystole. Given the retrospective nature of this work, we were unable to fully address selection bias or resuscitation time bias and cannot comment on causality.
conclusionIn this national cohort, naloxone administration was associated with improved survival to hospital discharge for OHCA patients in PEA. No association was found between naloxone and clinical outcomes for OHCA patients with shockable rhythms or asystole. Prospective, randomized trials are needed to assess for true causality.
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