In this prospective single-center RCT, 100 patients with in-hospital cardiac arrest (asystole/PEA or Vtach/Vfib unresponsive to 2 defibrillations) were randomized to epinephrine (1mg/cycle) + placebo, or epinephrine + vasopressin (20IU/cycle). The intervention group had higher return of spontaneous circulation at 15 minutes (81% versus 52%) and higher survival to hospital discharge (19% versus 4%). Of those surviving at 4 hours with evidence of shock (pressors needed to keep MAP >70), they were randomized to receive 40mg IV methylprednisolone (with maintenance 300mg IV hydrocortisone/day for 7 days) or placebo. The intervention group also had higher survival to hospital discharge (30% versus 0%) (abstract). These results are impressive, but will likely need to be validated by others centers before adoption by the AHA (site)
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January 13, 2009 |
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About the Author: Danielle Scheurer
Danielle Scheurer, MD, MSCR, SFHM is a clinical hospitalist and the Chief Quality Officer at the Medical University of South Carolina in Charleston, South Carolina, where she also serves as Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She is also the President of SHM's Board of Directors and previously served as Physician Editor of The Hospitalist, SHM's monthly newsmagazine.
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