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Does standard dose vasopressin alternatively high dose adrenaline show survival advantage in adult patients suffering from cardiac arrest compared to standard dose adrenaline?

Authors
  • Carlander, Robin
Publication Date
Jan 01, 2018
Source
DiVA - Academic Archive On-line
Keywords
Language
Swedish
License
Unknown
External links

Abstract

Cardiac arrest is a state when the heart has lost the ability to pump blood to the body which causes cerebral and coronary ischemia. Cardiac arrest is defined as sudden and sustained unconsciousness with pulselessness and suspension of breathing or agonal breathing. Common symptoms that can arise one hour before a cardiac arrest includes dizziness, tiredness, chest pain and breathing difficulties. The treatment for cardiac arrest in Sweden includes basic and advanced cardiac life support. The most important measures are cardiopulmonary resuscitation, defibrillation and drug administration. The drug of choice is standard dose adrenaline based on its vasoconstricting and thus blood pressure raising effect. The aim of this study was to evaluate the effect of standard dose vasopressin alternatively high dose adrenaline compared to standard dose adrenaline in adults with cardiac arrest. This study is a literature review where seven studies on the effect of standard dose adrenaline compared to standard dose vasopressin alternatively high dose adrenaline on cardiac arrest in adults have been analyzed. The studies were found in the database Pubmed. Four studies evaluate the effect on survival by standard dose vasopressin compared to standard dose adrenaline. Three studies evaluate the effect on survival by high dose adrenaline compared to standard dose adrenaline. Patients that were treated with standard dose vasopressin instead of the first or second standard dose adrenaline had better survival to hospital admission (31,6% compared to 26,0%, p <0,01). Patients that were treated with high dose adrenaline instead of standard dose adrenaline had better survival to hospital admission (26,1% compared to 23,1%, p <0,05). There were no effects on survival to hospital discharge for either standard dose vasopressin or high dose adrenaline. More studies are needed though with more patients to verify the results of this literature review. It would also be interesting with studies that focus on the different cardiac arrest rhytms. More research is needed about the potential negative effects on the heart and brain caused by high dose adrenaline. The reason for the bad results regarding survival to hospital discharge regardless of vasopressive treatment needs to be evaluated.

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