Comments on “The effects of norepinephrine in shockable cardiac arrest, a scoping review”

Norepinephrine in shockable cardiac arrest is a controversial topic. The review from Bouman et al. relies heavily on historical animal studies with limited human data, thus, their conclusion may not be clinically applicable. Current available data demonstrates significant heterogeneity, such as norepinephrine dosing and administration routes. Furthermore, a recent meta-analysis suggests no clear survival or neurologic benefit of norepinephrine over epinephrine. The assertions about neurologic outcomes, which were based on animal hemodynamics, were not supported by sufficient human evidence in the recent meta-analysis. Overall, the authors' conclusions may be too much of an overreach, due to given the variability and limitations of the included studies, warranting cautious interpretation.