Smartest Doc
Vasopressin for cardiac arrest: Meta-analysis of randomized controlled trials Full Text
Resuscitation, 07/26/2011
Evidence Based Medicine
Clinical Article
Mentzelopoulos SD et al.– Vasopressin use in the resuscitation of cardiac arrest patients is not associated with any overall benefit or harm. However, vasopressin may improve the long–term survival of asystolic patients, especially when average TDRUG is < 20min.
Methods- Two reviewers independently searched PubMed, EMBASE, and Cochrane Database for RCTs assigning adults with cardiac arrest to treatment with a vasopressin–containing regimen (vasopressin–group) vs adrenaline (epinephrine) alone (control–group) and reporting on long–term outcomes.
- Data from 4,475 patients in 6 high–methodological quality RCTs were analysed.
- Subgroup analyses were conducted according to initial cardiac rhythm and time from collapse to drug administration (TDRUG)<20min.
- Vasopressin vs. control did not improve overall rates of sustained ROSC, long–term survival, or favourable neurological outcome.
- However, in asystole, vasopressin vs. control was associated with higher long–term survival {odds ratio (OR)=1.80, 95% confidence interval (CI)=1.04–3.12, P=0.04}.
- In asystolic patients of RCTs with average TDRUG <20min, vasopressin vs. control increased the rates of sustained ROSC (data available from 2 RCTs; OR=1.70, 95% CI=1.17–2.47, P=0.005) and long–term survival (data available from 3 RCTs; OR=2.84, 95% CI=1.19–6.79, P=0.02).
