scholarly journals Vasopressin versus epinephrine for out–of–hospital cardiopulmonary resuscitation

CJEM ◽  
2005 ◽  
Vol 7 (01) ◽  
pp. 48-50
Author(s):  
Andrew Worster ◽  
Suneel Upadhye ◽  
Christopher M.B. Fernandes

Clinical question Does the use of vasopressin for adult patients suffering a non-traumatic, out-of-hospital cardiac arrest improve the rates of survival to hospital admission (and discharge) better than epinephrine?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Ken Nagao ◽  
Hiroyuki Hanada ◽  
Yoshio Tahara ◽  
Hiroshi Nonogi ◽  
Naohiro Yonemoto ◽  
...  

Background: The international consensus on cardiopulmonary resuscitation (CPR) and emergency cardiovascular care science with treatment recommendations (CoSTR) 2010 changed the dispatcher-initiated telephone CPR instruction. Major changes of the telephone CPR instruction were simplified algorithm, elimination of “Look, listen, and feel for breathing” chest compressions first (C-A-B), chest compression only CPR if bystander was not trained in CPR, et al. However, few studies have investigated the efficacy of telephone CPR instruction based on the CoSTR 2010. Methods: From the All-Japan Utstein Registry for out-of-hospital cardiac arrest (OHCA) between 2006 and 2015, we enrolled adult (18 years or older) patients with bystander-witnessed OHCA and stratified by the two CoSTR eras (the CoSTR 2010 group from 2011 through 2015 versus the CoSTR 2005 group from 2006 through 2010). The primary endpoint was 30-day favorable neurological outcome after OHCA. Results: Of the 378,757 adult patients with bystander-witnessed OHCA, 199,117 (52.5%) received CPR based on the CoSTR 2010 and 179,640 (47.4%) received CPR based on the CoSTR 2005. In the whole cohort, the CoSTR 2010 group had higher proportion of cases receiving telephone CPR instruction than the CoSTR 2005 group (48.8% versus 40.9%, P<0.001). In the subgroups of patients receiving telephone CPR instruction, the CoSTR 2010 group had higher proportion of bystander chest compression-only CPR (60.5% versus 47.3%, p<0.001) and public access defibrillation (1.9% versus 0.9%, P<0.001) than the CoSTR 2005 group. Although those subgroups had similar proportion of initial shockable cardiac arrest rhythm (15.2 % in the CoSTR 2010 group versus 15.3 % in the CoSTR 2005 group, P=0.63), the CoSTR 2010 group had higher frequency of the favorable neurological outcome than the CoSTR 2005 group (4.5 % versus 3.7%%, P<0.001). In the subgroup of patients receiving telephone CPR instruction, an adjusted odds ratio for the favorable neurological outcome in the CoSTR 2010 group (reference, the CoSTR 2005 group) was 1.47 (95 % CI, 1.43-1.51, p<0.001). Conclusions: Telephone CPR instruction based on the CoSTR 2010 was the preferable approach to resuscitation for adult patients with bystander-witnessed OHCA.


Author(s):  
Kaspars Setlers ◽  
Indulis Vanags ◽  
Anita Kalēja

Abstract A retrospective patient record analysis of the Emergency Medial Service’s Rîga City Regional Centre was provided from January 2012 through December 2013. 1359 adult patients were CPR treated for out-of-hospital cardiac arrest according to ERC Guidelines 2010. A total of 490 patients were excluded from the study. The main outcome measure was survival to hospital admission. Of 869 CPR-treated patients, 60% (n = 521) were men. The mean age of patients was 66.68 ± 15.28 years. The survival rate to hospital admission was 12.9% (n = 112). 54 of survived patients were women. Mean patient age of successful CPR was 63.22 ± 16.21 and unsuccessful CPR 67.20 ± 15.09. At least one related illness was recorded with 63.4% (n = 551) patients. There were 61 survivors in bystander witnessed OHCA and nine survivors in unwitnessed OHCA. The rate of bystander CPR when CA (cardiac arrest) was witnessed was 24.8%. Ventricular fibrillation (VF) as initial heart rhythm was significantly associated with survival to hospital admission in 54 cases (p < 0.0001). Age and gender affected return of spontaneous circulation. Survival to hospital admission had rhythm-specific outcome. Presence of OHCA witnesses improved outcome compared to bystander CPR. The objective of this study was to report patient characteristics, the role of witnesses in out-of-hospital cardiac arrest (OHCA) and outcome of adult cardiopulmonary resuscitation


2017 ◽  
Vol 35 (1) ◽  
pp. 65.2-66 ◽  
Author(s):  
Pierre-Alexandre LeBlanc ◽  
Alexandra Nadeau

A short cut review was carried out to establish whether continuous flow insufflation of oxygen (CFIO) is better than standard ventilation strategies at improving outcome in adults who have suffered an out-of-hospital cardiac arrest (OHCA). Papers were found in Medline and Embase using the reported searches of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that CFIO does not improve survival or return of spontaneous circulation compared with standard ventilation strategies in OHCA.


Resuscitation ◽  
2019 ◽  
Vol 135 ◽  
pp. 66-72 ◽  
Author(s):  
Daisuke Kobayashi ◽  
Tetsuhisa Kitamura ◽  
Kosuke Kiyohara ◽  
Chika Nishiyama ◽  
Sumito Hayashida ◽  
...  

Author(s):  
Akihiko Inoue ◽  
Toru Hifumi ◽  
Tetsuya Sakamoto ◽  
Yasuhiro Kuroda

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) followed by targeted temperature management has been demonstrated to significantly improve the outcomes of out‐of‐hospital cardiac arrest (OHCA) in adult patients. Although recent narrative and systematic reviews on extracorporeal life support in the emergency department are available in the literature, they are focused on the efficacy of ECPR, and no comprehensively summarized review on ECPR for OHCA in adult patients is available. In this review, we aimed to clarify the prevalence, pathophysiology, predictors, management, and details of the complications of ECPR for OHCA, all of which have not been reviewed in previous literature, with the aim of facilitating understanding among acute care physicians. The leading countries in the field of ECPR are those in East Asia followed by those in Europe and the United States. ECPR may reduce the risks of reperfusion injury and deterioration to secondary brain injury. Unlike conventional cardiopulmonary resuscitation, however, no clear prognostic markers have been identified for ECPR for OHCA. Bleeding was identified as the most common complication of ECPR in patients with OHCA. Future studies should combine ECPR with intra‐aortic balloon pump, extracorporeal membrane oxygenation flow, target blood pressure, and seizure management in ECPR.


2020 ◽  
Vol 103 (5) ◽  
pp. 481-487

Objective: To determine the success rates of adult cardiopulmonary resuscitation (CPR) and identify the predictors of successful CPR at the emergency room (ER) at a university-based hospital. Materials and Methods: Adult patients that experienced cardiac arrest and received CPR at the ER were prospectively observed. The primary outcomes were the rates of return of spontaneous circulation (ROSC), survival to hospital admission, survival to hospital discharge, and discharge with good neurological outcome. The secondary outcome was to determine the predictors of ROSC. Results: One hundred twenty-nine adult patients were enrolled in the study. The success rates of CPR were ROSC 41.9%, survived to hospital admission 34.1%, survived to hospital discharge 8.5%, and discharged with a good neurologic outcome 3.9%. From multiple logistic regression, the predicting factors for ROSC were cardiac arrest at the ER (odds ratio [OR] 4.89, 95% CI 1.90 to 12.55; p<0.001) and cardiac arrest during morning shift (OR 2.40, 95% CI 1.08 to 5.34; p=0.031). Conclusion: The success rates of the CPR outcomes were good. Cardiac arrest at the ER and arrest during the daytime were predicting factors for ROSC. Keywords: Adult cardiopulmonary resuscitation, Cardiac arrest, Emergency room


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