Izvorni znanstveni članak
Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis
XIAO-LI JING
; Department of Emergency; The First Affiliated Hospital; Sun Yat-Sen University; 58 Zhongshan Road II, Guangzhou, Guangdong 510080; China
DONG-PING WANG
; Department of Organ Transplantation; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou 510080; China
XIN LI
; Department of Emergency; The First Affiliated Hospital; Sun Yat-Sen University; 58 Zhongshan Road II, Guangzhou, Guangdong 510080; China
HUI LI
; Department of Emergency; The First Affiliated Hospital; Sun Yat-Sen University; 58 Zhongshan Road II, Guangzhou, Guangdong 510080; China
XIAO-XING LIAO
; Department of Emergency; The First Affiliated Hospital; Sun Yat-Sen University; 58 Zhongshan Road II, Guangzhou, Guangdong 510080; China
YAN XIONG
; Department of Emergency; The First Affiliated Hospital; Sun Yat-Sen University; 58 Zhongshan Road II, Guangzhou, Guangdong 510080; China
XI-FU WANG
; Department of Emergency; The First Affiliated Hospital; Sun Yat-Sen University; 58 Zhongshan Road II, Guangzhou, Guangdong 510080; China
Sažetak
Objective. A combination of vasopressin and epinephrine may be more effective than epinephrine alone in cardiopulmonary resuscitation (CPR), but evidence is lacking to make clinical recommendations. This meta-analysis compares the efficacy of vasopressin and epinephrine used together versus epinephrine alone in cardiac arrest (CA).
Methods. We searched MEDLINE and EMBASE for randomized trials comparing the efficacy of vasopressin and epinephrine versus epinephrine alone in adults with cardiac arrest. The primary outcome was the return of spontaneous circulation (ROSC) and the survival rate on admission and discharge .We also analyzed ROSC in subgroups of patients presenting with different arrest rhythms, such as asystole, pulseless electrical activity (PEA), ventricular fibrillation (VF).
Results. We analyzed 6 randomized trials out of 485 articles. We did not find evidence supporting the superiority of vasopressin and epinephrine used in combination, except for the survival rate at 24h 2.99 95% CI(1.43,6.28). No evidence supports the conclusion that vasopressin combined with epinephrine is better than epinephrine alone for ROSC, even amongst subgroups of patients.
Conclusion. This systematic review of the efficacy of vasopressin and epinephrine use found that its combined use is better for 24h survival rate but only in one study which included 122 patients. Further investigation will be needed to support the use of this combination for cardiac arrest management.
Ključne riječi
cardiopulmonary resuscitation; meta-analysis; epinephrine; vasopressin
Hrčak ID:
51530
URI
Datum izdavanja:
1.4.2010.
Posjeta: 1.348 *