Hostname: page-component-6d856f89d9-8l2sj Total loading time: 0 Render date: 2024-07-16T06:24:53.420Z Has data issue: false hasContentIssue false

Improved neurologic outcomes after cardiac arrest with combined administration of vasopressin, steroids, and epinephrine compared to epinephrine alone

Published online by Cambridge University Press:  01 April 2015

Tudor Botnaru*
Affiliation:
Emergency Medicine Residency Program, McGill University Health Centre, Montreal, QC
Tawfeeq Altherwi
Affiliation:
Emergency Medicine Residency Program, McGill University Health Centre, Montreal, QC
Jerrald Dankoff
Affiliation:
Department of Emergency Medicine, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC
*
Correspondence to: Dr. Tudor Botnaru, Emergency Medicine Residency Program, McGill University Health Centre, 687 Pine Avenue West, Room A4.62, Montreal, QC H3A 1A1; tudor.botnaru@mail.mcgill.ca

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Clinical question

Is a vasopressin, steroid, and epinephrine (VSE) protocol for in-hospital cardiac arrest resuscitation associated with better survival to hospital discharge with favourable neurologic outcome compared to epinephrine alone?

Article chosen

Mentzelopoulos S, Malachias S, Konstantopoulos D, et al. Vasopressin, steroids, and epinephrine and neurologically favorable survival after in-hospital cardiac arrest: a randomized clinical trial. JAMA 2013;310:270-9.

Objective

To determine if a VSE protocol during cardiopulmonary resuscitation with hydrocortisone administration in patients with postresuscitative shock at 4 hours after return of spontaneous circulation would improve survival to hospital discharge with favourable neurologic outcome.

Type
Knowledge to Practice: Journal Club
Copyright
Copyright © Canadian Association of Emergency Physicians 2015 

References

1. Bernard, SA, Gray, TW, Buist, MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346:557563, doi:10.1056/NEJMoa003289.CrossRefGoogle ScholarPubMed
2. Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346:549556, doi:10.1056/NEJMoa012689.CrossRefGoogle Scholar
3. Aufderheide, TP, Frascone, RJ, Wayne, MA, et al. Standard cardiopulmonary resuscitation versus active compressiondecompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiac arrest: a randomised trial. Lancet 2011;377:301311, doi:10.1016/S0140-6736(10)62103-4.CrossRefGoogle ScholarPubMed
4. Aufderheide, TP, Nichol, G, Rea, TD, et al. Resuscitation Outcomes Consortium (ROC) Investigators A trial of an impedance threshold device in out-of-hospital cardiac arrest. N Engl J Med 2011;365:798806, doi:10.1056/NEJMoa 1010821.CrossRefGoogle ScholarPubMed
5. Wenzel, V, Krismer, AC, Arntz, HR, et al. European Resuscitation Council Vasopressor during Cardiopulmonary Resuscitation Study Group A comparison of vasopressin and epinephrine for out-of-hospital cardiopulmonary resuscitation. N Engl J Med 2004;350:105113, doi:10.1056/NEJMoa025431.CrossRefGoogle ScholarPubMed
6. Gueugniaud, PY, David, JS, Chanzy, E, et al. Vasopressin and epinephrine vs epinephrine alone in cardiopulmonary resuscitation. N Engl J Med 2008;359:2130, doi:10.1056/NEJMoa0706873.CrossRefGoogle ScholarPubMed
7. Mentzelopoulos, SD, Zakynthinos, SG, Tzoufi, M, et al. Vasopressin, epinephrine, and corticosteroids for in-hospital cardiac arrest. Arch Intern Med 2009;169:1524, doi:10.1001/archinternmed.2008.509.CrossRefGoogle ScholarPubMed
8. Nolan, JP, Deakin, CD, Soar, J, et al. European Resuscitation Council European Resuscitation Council guidelines for resuscitation 2005: Section 4, Adult advanced life support. Resuscitation 2005;67(Suppl 1):S3986, doi:10.1016/j.resuscitation.2005.10.009.CrossRefGoogle ScholarPubMed
9. Wallmuller, C, Meron, G, Kurkciyan, I, et al. Causes of inhospital cardiac arrest and influence on outcome. Resuscitation 2012;83:12061211, doi:10.1016/j.resuscitation.2012.05.001.CrossRefGoogle ScholarPubMed
10. American Heart Association. Part 4: Advanced Life Support. Circulation 2005;112:III-25-54 doi:10.1161/CIRCULATION AHA.105.166474.Google Scholar
11. Morrison, LJ, Deakin, CD, Morley, PT, et al. Part 8: Advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation 2010;122(16 Suppl 2):S345421, doi:10.1161/CIRCULATI ONAHA.110.971051.CrossRefGoogle ScholarPubMed
12. Abella, BS, Alvarado, JP, Myklebust, H, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 2005;293:305310, doi:10.1001/jama.293.3.305.CrossRefGoogle ScholarPubMed
13. Neumar, RW, OttoCW, LinkMS, et al 2010 American Heart AssociationGuidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science. Part 8: Adult Advanced Cardiovascular Life Support. Circulation 2010;122:S72967, doi:10.1161/CIRCULATIONAHA.110.970988.CrossRefGoogle Scholar
14. Shizukuda, Y, Miura, T, Ishimoto, R, et al. Effect of prednisolone on myocardial infarct healing: characteristics and comparison with indomethacin. Can J Cardiol 1991;7:447454.Google ScholarPubMed
15. Kayser, RG, Ornato, JP, Perbedy, MA. Cardiac arrest in the emergency department: a report from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 2008;78:151160, doi:10.1016/j.resuscitation.2008.03.007.CrossRefGoogle ScholarPubMed
16. Ajam, K, Gold, LS, Beck, SS, et al. Reliability of the Cerebral Performance Category to classify neurological status among survivors of ventricular fibrillation arrest: a cohort study. Scand J Trauma Resusc Emerg Med 2011;19:38 doi:10.1186/1757-7241-19-38.CrossRefGoogle ScholarPubMed
17. Jacobs, I, Nadkarni, V, Bahr, J, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports. Circulation 2004;110:33853397, doi:10.1161/01.CIR.0000147236.85306.15.CrossRefGoogle ScholarPubMed