title: Amiodarone and cardiac arrest: Systematic review and meta-analysis.
abstract: BACKGROUND
  The 2015 Guidelines for Resuscitation recommend amiodarone as the antiarrhythmic drug of choice in the treatment of resistant ventricular fibrillation or pulseless ventricular tachycardia. We reviewed the effects of amiodarone on survival and neurological outcome after cardiac arrest.
  
  
  METHODS
  We systematically searched MEDLINE and Cochrane Library from 1940 to March 2016 without language restrictions. Randomized control trials (RCTs) and observational studies were selected.
  
  
  RESULTS
  Our search initially identified 1663 studies, 1458 from MEDLINE and 205 from Cochrane Library. Of them, 4 randomized controlled studies and 6 observational studies met the inclusion criteria and were selected for further review. Three randomized studies were included in the meta-analysis. Amiodarone significantly improves survival to hospital admission (OR=1.402, 95% CI: 1.068-1.840, Z=2.43, P=0.015), but neither survival to hospital discharge (RR=0.850, 95% CI: 0.631-1.144, Z=1.07, P=0.284) nor neurological outcome compared to placebo or nifekalant (OR=1.114, 95% CI: 0.923-1.345, Z=1.12, P=0.475).
  
  
  CONCLUSIONS
  Amiodarone significantly improves survival to hospital admission. However there is no benefit of amiodarone in survival to discharge or neurological outcomes compared to placebo or other antiarrhythmics.
authors.affiliation: National and Kapodistrian University of Athens, Medical School, M.Sc. "Cardiopulmonary Resuscitation, Athens, Greece; A. Fleming General Hospital, Department of Internal Medicine, Athens, Greece.
authors.forename: Ageliki
authors.initials: A
authors.lastname: Laina
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Evaggelismos Hospital, 1st Department of Intensive Care Medicine, Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Karlis
authors.affiliation: Aristotle University of Thessaloniki, Hippokratio General Hospital, Clinical Research and Evidence-Based Medicine Unit, Thessaloniki, Greece.
authors.forename: Aris
authors.initials: A
authors.lastname: Liakos
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Department of Clinical Therapeutics, Vascular Laboratory, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Georgiopoulos
authors.affiliation: A. Fleming General Hospital, Department of Internal Medicine, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Oikonomou
authors.affiliation: National and Kapodistrian University of Athens, Medical School, M.Sc. "Cardiopulmonary Resuscitation, Athens, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Kouskouni
authors.affiliation: National and Kapodistrian University of Athens, Medical School, M.Sc. "Cardiopulmonary Resuscitation, Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece. Electronic address: thanoschalkias@yahoo.gr.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Chalkias
authors.affiliation: Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; European University Cyprus, School of Medicine, Nicosia, Cyprus.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Xanthos
mesh_terms: D000638:Amiodarone / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D006323:Heart Arrest / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D064887:Observational Studies as Topic / Q000379:methods; D010343:Patient Admission / Q000639:trends; D010351:Patient Discharge / Q000639:trends; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D015996:Survival Rate / Q000639:trends
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone
keywords: Amiodarone; Cardiac arrest; Cardiopulmonary resuscitation; Meta-analysis; Systematic review