The Effect of Vasopressin and Methylprednisolone on Return of Spontaneous Circulation in Patients with In-Hospital Cardiac Arrest: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abdelazeem, Basel; Awad, Ahmed K.; Manasrah, Nouraldeen; Elbadawy, Merihan A.; Ahmad, Soban; Savarapu, Pramod; Abbas, Kirellos Said; Kunadi, Arvind

doi:10.1007/s40256-022-00522-z

Cited by 4 publications

(3 citation statements)

References 40 publications

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“…Multiple randomized controlled trials (RCTs) have been done comparing high-dose with standard-dose epinephrine, and although some have shown higher rates of ROSC with high-dose epinephrine, none have shown improvement in survival to discharge or any longer-term outcomes. 7–14…”

Section: Vasopressor Medications During Cardiac Arrestmentioning

confidence: 99%

“…6 Timely revascularization for postarrest patients appeared to be associated with a mortality benefit that persisted after attempts to control for confounders. 2,7–11 Thus, the prior recommendations, leveraging these best available data, recommended emergency coronary angiography for patients with ST-segment elevation and suggested emergency angiography in select patients (eg, hemodynamically and electrically unstable) without ST-segment elevation. 12 Notably, no recommendation was made for stable patients without ST-segment elevation.…”

Section: Percutaneous Coronary Intervention After Cardiac Arrestmentioning

confidence: 99%

“…1 Patients with cardiac arrest make up an important growing pool of potential organ donors 2–4 because cardiac arrest is common and a substantial proportion of those who cannot recover from cardiac arrest are still able to become organ donors. 2,5–9 However, organ donation is rarely reported as an outcome in cardiac arrest clinical trials or as a metric in large registry data.…”

Section: Organ Donation After Cardiac Arrestmentioning

confidence: 99%

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2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Perman,

Elmer,

Maciel

et al. 2024

Circulation

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Cardiac arrest is common and deadly, affecting up to 700 000 people in the United States annually. Advanced cardiac life support measures are commonly used to improve outcomes. This “2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support” summarizes the most recent published evidence for and recommendations on the use of medications, temperature management, percutaneous coronary angiography, extracorporeal cardiopulmonary resuscitation, and seizure management in this population. We discuss the lack of data in recent cardiac arrest literature that limits our ability to evaluate diversity, equity, and inclusion in this population. Last, we consider how the cardiac arrest population may make up an important pool of organ donors for those awaiting organ transplantation.

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Section: Vasopressor Medications During Cardiac Arrestmentioning

confidence: 99%

Section: Percutaneous Coronary Intervention After Cardiac Arrestmentioning

confidence: 99%

Section: Organ Donation After Cardiac Arrestmentioning

confidence: 99%

See 1 more Smart Citation

2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Perman,

Elmer,

Maciel

et al. 2024

Circulation

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Effectiveness of Vasopressin Against Cardiac Arrest: A Systematic Review of Systematic Reviews

Ho,

Tam,

Leung

2024

Cardiovasc Drugs Ther

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Purpose This systematic review (SR) of SRs evaluates the effectiveness of vasopressin alone or in combination with other drugs in improving the outcomes of cardiac arrest (CA). Methods Using a three-step approach, we searched five databases to identify all relevant SRs. Two reviewers independently selected suitable studies, assessed study quality, and extracted relevant data. If an outcome was reported by multiple SRs, a re-meta-analysis was conducted as needed; otherwise, a narrative analysis was performed. Results Twelve SRs covering 16 original studies were included in this review. The meta-analysis results revealed a significant increase in survival to hospital admission for patients with in-hospital CA (IHCA) or out-of-hospital CA (OHCA) receiving vasopressin alone compared with that for those receiving epinephrine alone. Furthermore, the return of spontaneous circulation (ROSC) was significantly increased in patients with OHCA receiving vasopressin with epinephrine compared with that in those receiving epinephrine alone. Compared with patients with IHCA receiving epinephrine with placebo, those receiving vasopressin, steroids, and epinephrine (VSE) exhibited significant increases in ROSC, survival to hospital discharge, favorable neurological outcomes, mean arterial pressure, renal failure–free days, coagulation failure–free days, and insulin requirement. Conclusion VSE is the most effective drug combination for improving the short- and long-term outcomes of IHCA. It is recommended to use VSE in patients with IHCA. Future studies should investigate the effectiveness of VSE against OHCA and CA of various etiologies, the types and standard dosages of steroids for cardiac resuscitation, and the effectiveness of vasopressin–steroid in improving CA outcomes.

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The Pharmacologic Management of Cardiac Arrest

Singh,

Heeney,

Montgomery

2024

Cardiology Clinics

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The Effect of Vasopressin and Methylprednisolone on Return of Spontaneous Circulation in Patients with In-Hospital Cardiac Arrest: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Cited by 4 publications

References 40 publications

2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Effectiveness of Vasopressin Against Cardiac Arrest: A Systematic Review of Systematic Reviews

The Pharmacologic Management of Cardiac Arrest

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