Vasopressin, epinephrine, and methylprednisolone in inhospital cardiac arrest

Introduction

Combined vasopressin, epinephrine, and methylprednisolone during cardiopulmonary resuscitation (CPR) may improve survival in inhospital cardiac arrest.

Methods

Ninety-one adults with cardiac arrest were randomized to receive either vasopressin (20 IU/CPR cycle for five cycles) plus epinephrine (1 mg/CPR cycle) plus methylprednisolone (single dose = 40 mg) or placebo plus epinephrine (1 mg/CPR cycle) plus placebo. Primary endpoints were return of spontaneous circulation (ROSC) for ≥15 minutes, and survival to discharge either to home or to a rehabilitation facility.

Results

Study group patients had higher rates of ROSC (37/44 vs 24/47; P < 0.01) and discharge either to home or to a rehabilitation facility (7/44 vs 1/47; P < 0.05). Sixty-day survival was improved in the study group (Figure 1).

Figure 1

Conclusion

Combination treatment improves survival in inhospital cardiac arrest.