| Drug treatment and thrombolytics during cardiopulmonary resuscitation. | |
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MedLine Citation:
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PMID: 16552222 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: During cardiopulmonary resuscitation, no specific drug therapy has been shown to improve survival to hospital discharge after cardiac arrest, and only few drugs have a proven benefit for short-term survival. This article reviews recent experimental and clinical data about vasopressor, antiarrhythmic and thrombolytic agents. RECENT FINDINGS: General use of high-dose epinephrine (>1 mg) can not be recommended, whereas it should be considered during prolonged cardiopulmonary resuscitation. No catecholamine superior to epinephrine has been identified. Arginine vasopressin has been shown to be as effective as epinephrine in patients with ventricular fibrillation and pulseless electrical activity, and may be more effective in patients presenting with asystole or as the second vasopressor (after epinephrine) in refractory cardiac arrest. Sodium bicarbonate should not be 'blindly' administered during cardiopulmonary resuscitation unless an arterial blood gas analysis can be obtained, or after prolonged unsuccessful cardiopulmonary resuscitation. Amiodarone should be preferred over lidocaine, since it may improve short-term survival. Thrombolytic therapy during cardiopulmonary resuscitation may be beneficial if a pulmonary embolism or acute myocardial infarction is suggested to be the cause of the cardiac arrest. SUMMARY: Epinephrine still represents the first-line vasopressor during cardiopulmonary resuscitation. Arginine vasopressin may be considered in patients presenting with asystole or who are unresponsive to initial treatment with epinephrine. Amiodarone should be preferred to other antiarrythmic agents in patients with cardiac arrest. Thrombolytic therapy during cardiopulmonary resuscitation is a promising new therapeutic option, but its general use in cardiac arrest cannot be recommended until the results of a large multicentre trial become available. |
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Authors:
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Fabian Spöhr; Volker Wenzel; Bernd W Böttiger |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in anaesthesiology Volume: 19 ISSN: 0952-7907 ISO Abbreviation: Curr Opin Anaesthesiol Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-03-22 Completed Date: 2006-09-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8813436 Medline TA: Curr Opin Anaesthesiol Country: United States |
Other Details:
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Languages: eng Pagination: 157-65 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology, University of Heidelberg, Heidelberg, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiopulmonary Resuscitation* Fibrinolytic Agents / therapeutic use* Humans |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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