Vasopression and steroids for cardiac arrest

By  |  January 13, 2009 | 

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)

About the Author:

Danielle Scheurer
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is 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 also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.

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