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Use of beta-blockers for the Treatment of Cardiac Arrest due to Ventricular Fibrillation/Pulseless Ventricular Tachycardia: a Systematic Review.
MedLine Citation:
PMID:  22306254     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Advanced Life Support guidelines recommend the use of epinephrine during Cardiopulmonary Resuscitaion (CPR), as to increase coronary blood flow and perfusion pressure through its alpha-adrenergic peripheral vasoconstriction, allowing minimal rises in coronary perfusion pressure to make defibrillation possible. Contrasting to these alpha-adrenergic effects, epinephrine's beta-stimulation may have deleterious effects through an increase in myocardial oxygen consumption and a reduction of subendocardial perfusion, leading to postresuscitation cardiac dysfunction. Objective: The present paper consists of a systematic review of the literature regarding the use of beta-blockade in cardiac arrest due to ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). Methods: Studies were identified through MEDLINE electronic databases research and were included those regarding the use of beta-blockade during CPR. Results: Beta-blockade has been extensively studied in animal models of CPR. These studies not only suggest that beta-blockade could reduce myocardial oxygen requirements and the number of shocks necessary for defibrillation, but also improve postresuscitation myocardial function, diminish arrhythmia recurrences and prolong survival. A few case reports described successful beta-blockade use in patients, along with two prospective human studies, suggesting that it could be safe and effectively used during cardiac arrest in humans. Conclusion: Even though the existing literature points towards a beneficial effect of beta-blockade in patients presenting with cardiac arrest due to VF/pulseless VT, high quality human trials are still lacking to answer this question definitely.
Authors:
Felipe Carvalho de Oliveira; Gilson Soares Feitosa-Filho; Luiz Eduardo Fonteles Ritt
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-1
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ireland Ltd.
Affiliation:
Escola Bahiana de Medicina e Saúde Pública, Rua Frei Henrique, n° 08, Nazaré. CEP: 40050-420-Salvador, BA, Brazil; Hospital Santa Izabel-Santa Casa de Misericórdia da Bahia, Hospital Santa Izabel, Praça Almeida Couto, 500, Nazaré - 40050-410 Salvador, BA, Brazil.
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