Vasopressin improves outcome in out-of-hospital cardiopulmonary resuscitation of ventricular fibrillation and pulseless ventricular tachycardia: a observational cohort study

Štefek Grmec (Avtor), Štefan Mally (Avtor)

Povzetek

Introduction An increasing body of evidence from laboratory and clinical studies suggests that vasopressin may represent a promising alternative vasopressor for use during cardiac arrest and resuscitation. Current guidelines for cardiopulmonary resuscitation recommend the use of adrenaline (epinephrine), with vasopressin considered only as a secondary option because of limited clinical data. Method The present study was conducted in a prehospital setting and included patients with ventricular fibrillation or pulseless ventricular tachycardia undergoing one of three treatments: group I patients received only adrenaline 1 mg every 3 minutes; group II patients received one intravenous dose of arginine vasopressine (40 IU) after three doses of 1 mg epinephrine; and patients in group III received vasopressin 40 IU as first-line therapy. The cause of cardiac arrest (myocardial infarction or other cause) was established for each patient in hospital. Results A total of 109 patients who suffered nontraumatic cardiac arrest were included in the study. The rates of restoration of spontaneous circulation and subsequent hospital admission were higher in vasopressin-treated groups (23/53 [45%] in group I, 19/31 [61%] in group II and 17/27 [63%] in group III). There were also higher 24-hour survival rates among vasopressin-treated patients (P < 0.05), and more vasopressin-treated patients were discharged from hospital (10/51 [20%] in group I, 8/31 [26%] in group II and 7/27 [26%] group III; P = 0.21). Especially in the subgroup of patients with myocardial infarction as the underlying cause of cardiac arrest, the hospital discharge rate was significantly higher in vasopressin-treated patients (P < 0.05). Among patients who were discharged from hospital, we found no significant differences in neurological status between groups. Conclusion The greater 24-hour survival rate in vasopressin-treated patients suggests that consideration of combined vasopressin and adrenaline is warranted for the treatment of refractory ventricular fibrillation or pulseless ventricular tachycardia. This is especially the case for those patients with myocardial infarction, for whom vasopressin treatment is also associated with a higher hospital discharge rate.

Ključne besede

Tahikardija, prekatna;

Podatki

Jezik:	Angleški jezik
Leto izida:	2006
Tipologija:	1.01 - Izvirni znanstveni članek
Organizacija:	UM MF - Medicinska fakulteta
UDK:	616.1
COBISS:	2183487
ISSN:	1466-609X
Št. ogledov:	1249
Št. prenosov:	149
Ocena:	0 (0 glasov)
Metapodatki:

Ostali podatki

Sekundarni jezik:	Slovenski jezik
Sekundarne ključne besede:	Vasopressins;Vazopresini;Heart arrest;Srce, zastoj;Cardiopulmonary resuscitation;Kardiopulmonarno oživljanje;Ventricular fibrillation;Prekatna fibrilacija;Tachycardia, ventricular;Emergency medical services;Službe nujne medicinske pomoči;
URN:	URN:SI:UM:
Vrsta dela (COBISS):	Znanstveno delo
Strani:	[str. 1-7]
Letnik:	ǂVol. ǂ10
Zvezek:	ǂno. ǂ1
Čas izdaje:	2006
DOI:	10.1186/cc3967
ID:	10845026