title: Bretylium tosylate as initial treatment for cardiopulmonary arrest: randomized comparison with placebo.
abstract: To evaluate the therapeutic effectiveness of intravenous bretylium tosylate as a first-line drug for patients in cardiopulmonary arrest, a randomized, double-blind study was conducted, comparing bretylium with a normal saline placebo. Fifty-nine patients presenting to the emergency department with cardiopulmonary arrest due mainly to ventricular fibrillation or asystole initially received either bretylium (10 mg/kg) or placebo in a rapid intravenous bolus and were then otherwise treated according to standard American Heart Association guidelines. If ventricular fibrillation or asystole persisted, a second bolus of bretylium or normal saline was given after 20 minutes. Thirty-five percent of patients presenting with ventricular fibrillation or asystole who received bretylium were successfully resuscitated, whereas 6% of patients who received placebo survived (P less than 0.05). These findings serve to suggest that the early use of bretylium tosylate in cardiopulmonary arrest improves survival.
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001949:Bretylium Compounds / Q000008:administration & dosage*; D001950:Bretylium Tosylate / Q000008:administration & dosage*; D004311:Double-Blind Method; D004341:Drug Evaluation; D005260:Female; D006323:Heart Arrest / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011897:Random Allocation; D012151:Resuscitation
chemical_list: D000889:Anti-Arrhythmia Agents; D001949:Bretylium Compounds; D010919:Placebos; D001950:Bretylium Tosylate