Document Detail


Thrombolysis and other drugs during cardiopulmonary resuscitation.
MedLine Citation:
PMID:  18467889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: No specific drug therapy has been shown to improve long-term survival after cardiac arrest, and only few drugs have a proven benefit for short-term survival. This study reviews recent studies on drugs during cardiopulmonary resuscitation. RECENT FINDINGS: Epinephrine is the first-line vasopressor during cardiopulmonary resuscitation. Arginine vasopressin may be more effective than epinephrine in patients presenting with asystole or as a second vasopressor 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 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 cardiac arrest. SUMMARY: Epinephrine is the vasopressor of first choice for routine use 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 used in shock-refractory ventricular fibrillation. Although not recommended for routine use, thrombolytic therapy during cardiopulmonary resuscitation may be considered in patients with suspected pulmonary embolism or after unsuccessful conventional cardiopulmonary resuscitation in patients with a presumably thrombotic cause of cardiac arrest.
Authors:
Fabian Spöhr; Volker Wenzel; Bernd W Böttiger
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  14     ISSN:  1531-7072     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-09     Completed Date:  2008-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  292-8     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Postsurgical Intensive Care, University of Cologne, Cologne, Germany.
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MeSH Terms
Descriptor/Qualifier:
Anti-Arrhythmia Agents / therapeutic use
Arginine Vasopressin / therapeutic use
Atropine / therapeutic use
Cardiopulmonary Resuscitation*
Epinephrine / therapeutic use
Fibrinolytic Agents / therapeutic use*
Heart Arrest / drug therapy*,  etiology,  therapy
Humans
Sodium Bicarbonate / therapeutic use
Vasoconstrictor Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Fibrinolytic Agents; 0/Vasoconstrictor Agents; 113-79-1/Arginine Vasopressin; 144-55-8/Sodium Bicarbonate; 51-43-4/Epinephrine; 51-55-8/Atropine

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