Conclusion
Our study demonstrated that patients with inhospital cardiac arrest who had a secondary VF or VT develop after an initial cardiac rhythm of PEA or asystole received epinephrine more frequently than did patients who did not have a secondary VF or VT develop. Furthermore, patients who had a secondary VF or VT develop had longer duration of cardiac arrest and received a larger total dose of epinephrine. A true association between increased epinephrine administration during cardiac arrest and development of secondary VF or VT would need to be confirmed in prospective studies. If this association were to be confirmed, extending the dosing interval of epinephrine might result in improved outcomes among patients with cardiac arrest and an initial rhythm of PEA or asystole.