J Korean Soc Emerg Med.  2009 Feb;20(1):26-33.

Short-term Outcomes of the Combination of Vasopressin and Epinephrine versus Epinephrine Alone for Out-of-hospital Cardiac Arrest: A Prospective Observational Study

• Lee SW
• Kim TY
• Rhee JE
• Kim KS
• Jo YH
• Lee JH

Abstract

PURPOSE
A recent study demonstrated that the effects of vasopressin were superior to epinephrine in patients with asystole. According to the Korean national registry of out-ofhospital cardiac arrest (OHCA), more than 2/3 of paients had asystole. This study was performed to evaluate whether the combined administration of vasopressin and epinephrine in the emergency department (ED) for patients with OHCA would increase survival and survival discharge.
METHODS
From October 2007 to June 2008, we changed the cardiopulmonary resuscitation (CPR) protocol in adult, non-traumatic OHCA in that 40 U of vasopressin was to be administered as soon as possible followed by epinephrine (VSP group). Data about cardiac arrest were collected using the Utstein templates. Data from January to September 2007, when vasopressin had not been used, were also collected for comparative analysis (EPN group). These two groups were compared in terms of rate of survival and survival discharge.
RESULTS
There were 59 and 62 patients in the EPN group and the VSP group, respectively. There were no significant differences in the baseline characteristics including age, cardiac rhythm of asystole, witnessed arrest, and bystander CPR. Survival was similar between the EPN group and VSP group (46% vs 57%, p=0.240) as was survival discharge (20% vs 15%, p=0.398, respectively).
CONCLUSION
The combination therapy of vasopressin and epinephrine during CPR for OHCA does not show any survival advantage over epinephrine alone.

Keyword

Cardiac arrest; Cardiopulmonary resuscitation; Treatment Outcome; Vasopressins

MeSH Terms

Adult
Cardiopulmonary Resuscitation
Emergencies
Epinephrine
Heart Arrest
Humans
Imidazoles
Nitro Compounds
Prospective Studies
Treatment Outcome
Vasopressins
Wit and Humor as Topic
Epinephrine
Imidazoles
Nitro Compounds
Vasopressins