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Báo cáo khoa học: "Vasopressin combined with epinephrine during cardiac resuscitation: a solution for the future"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Vasopressin combined with epinephrine during cardiac resuscitation: a solution for the future? | Available online http ccforum.eom content 10 1 125 Commentary Vasopressin combined with epinephrine during cardiac resuscitation a solution for the future Volker Wenzel and Karl H Lindner Department of Anesthesiology and Critical Care Medicine Innsbruck Medical University Austria Corresponding author Volker Wenzel Volker.Wenzel@uibk.ac.at Published 22 February 2006 This article is online at http ccforum.com content 10 1 125 2006 BioMed Central Ltd Critical Care 2006 10 125 doi 10.1186 cc4846 See related research by Grmec and Mally in this issue http ccforum.com content 10 1 R13 Abstract Epinephrine given during cardiopulmonary resuscitation CPR may cause beta-mimetic complications in the postresuscitation phase. Vasopressin may be an alternative vasopressor drug during CPR. A subgroup analysis of a large prospective CPR investigation and of retrospective CPR studies suggests that vasopressin may be especially beneficial when combined with epinephrine. Beneficial effects of adding vasopressin were observed in other catecholamine-refractory shock states as well such as vasodilatory shock and haemorrhagic shock. In order to maximize effects of any vasopressor during CPR rapid aggressive chest compressions must be ensured to maximize blood flow and to enable advanced cardiac life support drugs to reach the arterial vasculature. We suggest alternating injections of 1 mg epinephrine i.v. and 40 IU vasopressin i.v. every 3-5 minutes during CPR until spontaneous circulation can be achieved or CPR efforts are terminated. Epinephrine has been employed for cardiac resuscitation for approximately 100 years 1 although it is known that this drug increases myocardial oxygen consumption during cardiopulmonary resuscitation CPR and increases the likelihood of cardiac failure after restoration of spontaneous circulation 2 . In contrast vasopressin proved to be beneficial over epinephrine as regards improving coronary perfusion pressure during CPR and as regards improving .