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Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis

  • XIAO-LI JING1
  • DONG-PING WANG2
  • XIN LI1
  • HUI LI1
  • XIAO-XING LIAO1
  • YAN XIONG1
  • XI-FU WANG 1

1Department of Emergency The First Affiliated Hospital Sun Yat-Sen University

2Department of Organ Transplantation The First Affiliated Hospital of Sun Yat-Sen University

DOI: 10.22514/SV51.042010.3 Vol.5,Issue 1,April 2010 pp.20-26

Published: 27 April 2010

*Corresponding Author(s): XIN LI E-mail: xlidoct@hotmail.com

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Abstract

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 epineph-rine 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 vasopres-sin 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.

Key words

cardiopulmonary resus-citation, meta-analysis, epinephrine, vasopressin

Cite And Share

XIAO-LI JING,DONG-PING WANG,XIN LI,HUI LI,XIAO-XING LIAO,YAN XIONG,XI-FU WANG . Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis. Signa Vitae. 2010. 5(1);20-26.

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