20.500.12556/DKUM-66515 Vasopressin improves outcome in out-of-hospital cardiopulmonary resuscitation of ventricular fibrillation and pulseless ventricular tachycardia: a observational cohort study Introduction: An increasing body of evidence from laboratory and clinical studies suggests that vasopressin may represent a promising alternative vasopressor for use during cardiac arrest and resuscitation. Current guidelines for cardiopulmonary resuscitation recommend the use of adrenaline (epinephrine), with vasopressin considered only as a secondary option because of limited clinical data. Method: The present study was conducted in a prehospital setting and included patients with ventricular fibrillation or pulseless ventricular tachycardia undergoing one of three treatments: group I patients received only adrenaline 1 mg every 3 minutes; group II patients received one intravenous dose of arginine vasopressine (40 IU) after three doses of 1 mg epinephrine; and patients in group III received vasopressin 40 IU as first-line therapy. The cause of cardiac arrest (myocardial infarction or other cause) was established for each patient in hospital. Results: A total of 109 patients who suffered nontraumatic cardiac arrest were included in the study. The rates of restoration of spontaneous circulation and subsequent hospital admission were higher in vasopressin-treated groups (23/53 [45%] in group I, 19/31 [61%] in group II and 17/27 [63%] in group III). There were also higher 24-hour survival rates among vasopressin-treated patients (P < 0.05), and more vasopressin-treated patients were discharged from hospital (10/51 [20%] in group I, 8/31 [26%] in group II and 7/27 [26%] group III; P = 0.21). Especially in the subgroup of patients with myocardial infarction as the underlying cause of cardiac arrest, the hospital discharge rate was significantly higher in vasopressin-treated patients (P < 0.05). Among patients who were discharged from hospital, we found no significant differences in neurological status between groups. Conclusion: The greater 24-hour survival rate in vasopressin-treated patients suggests that consideration of combined vasopressin and adrenaline is warranted for the treatment of refractory ventricular fibrillation or pulseless ventricular tachycardia. This is especially the case for those patients with myocardial infarction, for whom vasopressin treatment is also associated with a higher hospital discharge rate. vasopressin antidiuretic hormone ADH out-of-hospital cardiopulmonary resuscitation ventricular fibrillation pulseless ventricular tachycardia antidiuretični hormon ADH izvenbolnišnično oživljanje reanimacija prekatna fibrilacija prekatna tahikardija brez tipnega utripa true false true Angleški jezik Slovenski jezik Znanstveno delo 2017-06-29 10:25:49 2017-06-29 10:26:46 2022-07-11 03:07:26 2019-07-11 15:50:05 2006 0 0 str. 1-7 Letn. 10 2006 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 1466-609X 616.1 1137983 2183487 10.1186/cc3967 1466-609X URN:SI:UM:DK:TC5QC4VY Critical_Care_2006_Grmec,_Mally_Vasopressin_improves_outcome_in_out-of-hospital_cardiopulmonary_resuscitation_of_ventricular_fibrillatio.pdf Critical_Care_2006_Grmec,_Mally_Vasopressin_improves_outcome_in_out-of-hospital_cardiopulmonary_resuscitation_of_ventricular_fibrillatio.pdf 1 F7EBB522A3583E4D24EFA8DEBF246AFB 5e4f25d037b9553233c83db5cf69d9f9745b4f336ae71acf7c9ed29dbe1a38ab 5231e8d5-7c0e-11eb-bb7a-00155d0001ca https://dk.um.si/Dokument.php?lang=slv&id=113333 http://ccforum.biomedcentral.com/articles/10.1186/cc3967 1 https://dk.um.si/Dokument.php?lang=slv&id=113332 Medicinska fakulteta 0 0 0