Document Detail


Comparative study of nifekalant versus amiodarone for shock-resistant ventricular fibrillation in out-of-hospital cardiopulmonary arrest patients.
MedLine Citation:
PMID:  20147846     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In Japan, intravenous nifekalant (NIF) was often used for direct current cardioversion-resistant ventricular fibrillation (VF), until the use of intravenous amiodarone (AMD) was approved in 2007. The defibrillatory efficacy of NIF and AMD has thus far not been compared for resuscitation. METHODS AND RESULTS: Between August 2007 and April 2009, 403 consecutive out-of-hospital patients with cardiopulmonary arrest were transferred to the Emergency Medical Service of Tokai University. Of these, 30 patients with first defibrillation failure or VF recurrence were enrolled for this NIF/AMD study. The final defibrillation success (and hospital survival rate) was 67% (10/15) in the AMD and 47% (7/15) in the NIF group. The discharge survival rate was 53% (8/15) in the AMD and 21% (4/15) in the NIF group (P = 0.06). Notably, all 4 survivors in the NIF group could take up normal daily life again, whereas this was restricted to only 2 patients from the 11 survivors in the AMD group. The difference is probably partly attributable to longer time from AMD administration to defibrillation success compared with NIF. In the cases of defibrillation failure, VF continued in 4/8 by NIF, however, asystole or pulseless electrical activity occurred in 4/5 patients by AMD. CONCLUSIONS: AMD may be borderline superior over NIF to facilitate defibrillation in out-of-hospital patients with cardiopulmonary arrest. However, from the view point of preservation of brain function, NIF is not inferior to AMD for CPR.
Authors:
Mari Amino; Koichiro Yoshioka; Tobias Opthof; Seiji Morita; Shunryo Uemura; Kozo Tamura; Tomokazu Fukushima; Shigeo Higami; Hiroyuki Otsuka; Kazuki Akieda; Makiyoshi Shima; Daisuke Fujibayashi; Tadashi Hashida; Sadaki Inokuchi; Itsuo Kodama; Teruhisa Tanabe
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  55     ISSN:  1533-4023     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  391-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. mariam@is.icc.u-tokai.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Amiodarone / administration & dosage,  adverse effects,  therapeutic use*
Anti-Arrhythmia Agents / administration & dosage,  adverse effects,  therapeutic use
Drug Therapy, Combination
Electric Countershock*
Emergency Service, Hospital*
Female
Heart Arrest / drug therapy*,  etiology,  therapy
Heart Diseases / complications
Humans
Male
Middle Aged
Prognosis
Pyrimidinones / administration & dosage,  adverse effects,  therapeutic use*
Survival Analysis
Treatment Outcome
Ventricular Fibrillation / drug therapy*,  etiology,  therapy
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Pyrimidinones; 130656-51-8/MS 551; 1951-25-3/Amiodarone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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