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A study comparing epinephrine and isoprenaline in patients with out-of-hospital cardiac arrest who have non-shockable heart rhythm

Verified siteRegistered drugNo placebo
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What is this trial about?

A plain-language summary of the goals, design and what participants do

This study focuses on treating patients with cardiac arrest, specifically when the heart has stopped beating in a pattern that cannot be treated with an electrical shock. The research compares two medications: isoprenaline and epinephrine (also known as adrenaline). These medications are given through direct injection into a vein during attempts to restart the heart.

The purpose is to find out if isoprenaline is more effective than epinephrine at achieving sustained heartbeat restoration in patients whose hearts have stopped beating outside of a hospital setting. Both medications are given as liquid solutions that are injected into the bloodstream during resuscitation efforts.

During the study, emergency medical service personnel will give either isoprenaline or epinephrine to patients experiencing cardiac arrest. The maximum daily dose of isoprenaline that may be given is 2.4 milligrams, while the maximum daily dose of epinephrine is 4 milligrams. The treatment period lasts for one day, during which medical professionals will monitor how the patient's heart responds to the medication.

The research process

The trial runs in 5 steps – from screening to follow-up. Each step says what happens and what the team monitors.

  1. Step 1

    Initial assessment

    Your eligibility for the study will be assessed during an out-of-hospital cardiac arrest event

    The medical team will confirm that you are 18 years or older and have a non-shockable heart rhythm (a specific type of heart activity pattern)

    The cardiac arrest must be witnessed by bystanders or emergency medical personnel

  2. Step 2

    Treatment administration

    You will receive one of two medications through an intravenous injection (directly into a vein):

    Either epinephrine (also known as adrenaline) as an injection solution

    Or isoprenaline hydrochloride as an infusion solution

  3. Step 3

    Immediate monitoring

    The medical team will monitor your heart's response to the medication for at least 20 minutes

    They will check if your heart returns to normal functioning (return of spontaneous circulation)

    They will also monitor if your heart rhythm changes from non-shockable to shockable pattern

  4. Step 4

    Hospital care

    If your condition stabilizes, you will be transported to the hospital

    The medical team will continue monitoring your response to treatment

    Your neurological condition will be evaluated during your hospital stay

  5. Step 5

    Follow-up

    Your health status will be monitored for 30 days after the event

    The medical team will assess your overall recovery and survival

Who can join the trial?

5 criteria

  • Must be 18 years or older
  • Must have experienced a cardiac arrest outside of hospital that was witnessed by bystanders and/or emergency medical personnel
  • Must have a non-shockable heart rhythm when first examined (this means the heart has either stopped completely - known as asystole, or is showing some electrical activity without effective pumping - known as PEA)
  • Must be receiving or about to receive advanced life support treatment from emergency medical service (EMS) personnel (this includes procedures like CPR, medication administration, and airway management)
  • Can be either male or female

Who cannot join the trial?

10 criteria

  • Patient under 18 years old (since age ranges indicate adult population only)
  • Patients with shockable heart rhythm (a heart rhythm that can be treated with an electric shock from a defibrillator)
  • Cardiac arrest not occurring in out-of-hospital setting
  • Known allergy or hypersensitivity to isoprenaline or epinephrine (medications used in the study)
  • Pregnancy or suspected pregnancy
  • Patients who have already received epinephrine or isoprenaline during the current cardiac arrest event
  • Traumatic cause of cardiac arrest
  • Presence of a Do Not Resuscitate (DNR) order (a legal order indicating the patient does not want emergency lifesaving treatment)
  • Patients who have already achieved return of spontaneous circulation
  • Family or legal representative refusing participation in the study
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Investigated drugs

  • Epinephrine

    is a medication that helps the heart beat stronger and faster during cardiac arrest. It works by constricting blood vessels and increasing heart rate, which helps maintain blood flow to vital organs during emergencies. It is commonly used as the standard medication in cardiac arrest situations.

  • Isoprenaline

    is a medication that stimulates the heart to beat faster and stronger, similar to epinephrine, but works in a slightly different way. It primarily affects the heart's rhythm and strength of contractions without causing as much blood vessel constriction. It is being studied as an alternative to epinephrine in treating cardiac arrest patients who have rhythms that cannot be treated with electrical shock (non-shockable rhythms).

What is already known about the treatment

  • Epinephrine

    A naturally occurring and synthetic hormone administered through injection that acts as a powerful stimulant of both alpha and beta adrenergic receptors, commonly used in emergency medicine for cardiac arrest situations. The medication works by constricting blood vessels, increasing heart rate and force of contractions, and improving blood flow to vital organs, making it a first-line treatment for cardiac arrest. It belongs to the class of medications called catecholamines and serves as a standard component in advanced cardiac life support protocols.

  • Isoprenaline

    A synthetic sympathomimetic drug administered through injection that primarily stimulates beta adrenergic receptors in the heart, causing an increase in heart rate and cardiac output without significant blood vessel constriction. The medication is used in the treatment of cardiac arrest, particularly in cases with slow heart rhythms, and works by directly affecting the heart muscle to improve its pumping function. It belongs to the beta-adrenergic agonist class of medications and represents an alternative approach to managing certain types of cardiac arrest.

Investigated diseases

Cardiac Arrest - A sudden loss of heart function where the heart stops beating effectively and pumping blood to the body. During cardiac arrest, blood flow to vital organs ceases abruptly, particularly affecting the brain and other crucial systems. The condition can occur due to various underlying heart problems, including electrical disturbances in heart rhythm. Cardiac arrest can present with two main types of heart rhythms: shockable and non-shockable. The condition develops suddenly and without warning, leading to immediate loss of consciousness. The person affected will not be breathing normally and will be unresponsive.
Trial detailsLast updated 2 Oct 2026
Age18+ yearsPhasePhase IIITrial ID2024-516074-29-00Estimated enrolment1 178 patientsSponsorOdense University Hospital

sourced from the EU Clinical Trials Register and site verification

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