加压素用于心脏骤停无优势
No Advantage of vasopressin for Cardiac Arrest
Survival to hospital discharge was similar in patients treated with vasopressin or epinephrine.
Current advanced cardiac life support (ACLS) guidelines recommend giving epinephrine every 3 to 5 minutes for patients in cardiac arrest. Vasopressin may replace the first or second epinephrine dose. Several studies have found no survival benefit for vasopressin (JW Emerg Med Jul 2 2008), but some investigators speculate that it might be advantageous in patients with prolonged arrest.
Investigators in Singapore randomized 727 patients with nontraumatic cardiac arrest to receive epinephrine (1 mg) or vasopressin (40 IU) as the first medication while ACLS proceeded in standard fashion. Arrest occurred outside the hospital in 585 patients (80%), and their mean time to emergency department arrival was 38 minutes. There were no significant differences between the vasopressin and epinephrine groups in rates of return of spontaneous circulation (32% and 30%), survival to hospital admission (22% and 17%), or survival to hospital discharge (2.9% and 2.3%).
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