| Author/Editor | Mally, Štefan; Jelatancev, Alina; Grmec, Štefek | |
| Title | Effects of epinephrine and vasopressin on end-tidal carbon dioxide tension and mean arterial blood pressure in out-of-hospital cardiopulmonary resuscitation: an observational study | |
| Type | članek | |
| Vol. and No. | Letnik 11, št. 2 | |
| Publication year | 2007 | |
| Language | eng | |
| Abstract | Background. Clinical data considering vasopressin as an equivalent option to epinephrine in cardiopulmonary resuscitation (CPR) is limited. The aim of this prehospital study was to assess whether the use of vasopressin during CPR contributes to higher end-tidal CO2 and mean arterial pressure (MAP) levels and thus improve the survival rate and neurological outcome. Methods. Two treatment groups of resuscitated patients in cardiac arrest were compared: in the epinephrine group patients received epinephrine 1 mg IV every three minutes only; in the vasopressin/epinephrine group patients received arginine vasopressin 40 units IV only or followed by epinephrine 1mg every three minutes during CPR. Values of end-tidal CO2 and MAP were recorded, and data were collected according to Utstein style. Results. 598 patients were included with no significant demographic or clinical differences between compared groups. Final end-tidal CO2 values and average values of MAP in patients with restoration of pulse were significantly higer in vasopressin/epinephrine group (p<0.01). Initial (OR: 18.65), average (OR: 2.86) and final end-tidal CO2 (OR: 2.26) as well as MAP at admission to hospital (OR: 1.79) were associated with 24 hours survival. Initial (OR: 1.61), average (OR: 1.47) and final end-tidal CO2 (OR: 2.67) as well as MAP (OR: 1.39) were associated with improved hospital discharge. In the vasopressin group significantly more pulse restorations and a better 24 hours survival rate were observed (p<0.05). Subgroup analysis of patients with initial asystole revealed higher hospital discharge rate when vasopressin was used (p=0.04). Neurological outcome in discharged patients was better in the vasopressin group (p=0.04). Conclusions. End-tidal CO2 and MAP are strong prognostic factors for the outcome of out-of-hospital cardiac arrest. (Abstract truncated at 2000 characters) | |
| Descriptors | HEART ARREST CARDIOPULMONARY RESUSCITATION VASOPRESSINS EPINEPHRINE SURVIVAL RATE CARBON DIOXIDE BLOOD PRESSURE |