Vasopressin as first-line therapy for cardiac arrest: a review of the guidelines and clinical-effectiveness

Tsakonas E, Spry C
Record ID 32011001267
Authors' recommendations: There does not appear to be additional evidence to support the use of a specific vasopressor as first line therapy during cardiac arrest. Several authors have brought attention to the somewhat poorer neurological outcomes among patients administered vasopressin. The superiority of vasopressin compared with epinephrine in asystole patients reported was not confirmed by others. An American RCT administered vasopressin second-line to one group of patients after epinephrine was administered first-line to both groups, also did not find any between-group differences in patient outcomes. Another RCT compared vasopressin plus epinephrine s to saline placebo plus epinephrine for up to 5 resuscitation cycles, however the vasopressin group also received a corticosteroid during the first cycle. Better ROSC and survival to hospital discharge were reported in the vasopressin group; however, it is difficult to ascertain the extent to which this outcome was attributable to the addition of corticosteroids.Information from on-going and future trials may provide additional evidence about the clinical-effectiveness of vasopressin over epinephrine for cardiac arrest patients. In the interim, the decision to use one vasopressor over another may be dependent on clinical opinion and possibly cost.
Project Status: Completed
Year Published: 2009
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Arginine Vasopressin
  • Cardiopulmonary Resuscitation
Organisation Name: Canadian Agency for Drugs and Technologies in Health
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
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Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)
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