Treatment of Adrenaline Crash
Understanding the Clinical Context
The term "adrenaline crash" does not appear in established medical literature or clinical guidelines. The provided evidence exclusively addresses exogenous adrenaline (epinephrine) administration during cardiac arrest and anaphylaxis, not the physiological phenomenon of endogenous catecholamine depletion or "crash" states.
If Referring to Post-Cardiac Arrest Care
If you are asking about managing patients after adrenaline administration during resuscitation, the focus shifts entirely to post-resuscitation care rather than treating an "adrenaline crash."
Post-Resuscitation Management
Targeted temperature management (TTM) is the primary intervention after return of spontaneous circulation (ROSC), with guidelines recommending mild hypothermia (32°C–34°C) for 24 hours to improve neurological outcomes 1.
Hemodynamic support focuses on maintaining adequate perfusion pressure and cardiac output, not on counteracting adrenaline effects 1.
Avoid additional sympathomimetic agents unless specifically indicated for hemodynamic instability, as the concern during cardiac arrest is that high-dose adrenaline may worsen post-arrest outcomes through increased myocardial oxygen consumption and contraction band necrosis 1.
If Referring to Endogenous Catecholamine Depletion
There is no evidence-based treatment protocol for "adrenaline crash" as a distinct clinical entity. The provided guidelines do not address this condition because it is not a recognized medical diagnosis requiring specific pharmacological intervention.
Clinical Approach to Suspected Catecholamine Depletion
Supportive care is the mainstay: rest, hydration, and time for physiological recovery.
Avoid administering exogenous adrenaline for non-life-threatening conditions, as guidelines specifically caution against inappropriate use 2, 3.
Monitor for underlying conditions that may present similarly: adrenal insufficiency, severe sepsis, or cardiogenic shock requiring specific targeted therapy.
Critical Caveat
The evidence provided relates exclusively to adrenaline use in cardiac arrest (1 mg IV every 3-5 minutes) 1, 4 and anaphylaxis (0.3-0.5 mg IM) 4, 3. None of these guidelines address treating a "crash" state following endogenous or exogenous catecholamine exposure. If you are experiencing symptoms you attribute to an "adrenaline crash," this requires clinical evaluation to determine the actual underlying pathophysiology rather than empiric treatment based on a non-standard diagnosis.