Optimizing resuscitation outcomes with pharmacologic therapy.
Pharmacologic therapy plays a key role in the emergency resuscitation of patients with cardiac arrest. The Advanced Cardiac Life Support guidelines sanctioned by the American Heart Association provide flexible treatment protocols (algorithms) that serve as a valuable tool for clinicians. Vasoactive (vasopressive) therapy with epinephrine is of primary importance in all patients with nonperfusing rhythms (for example, ventricular fibrillation [VF], pulseless ventricular tachycardia [VT], electromechanical dissociation [EMD], and asystole) because it raises myocardial and cerebral perfusion pressures, thereby increasing the likelihood of successful resuscitation. Antiarrhythmic drugs play a secondary role to electrocardioversion in the treatment of VF and pulseless VT. Despite continued investigation and recent advances in our understanding of the role of drugs and other therapeutic interventions, the short-term and long-term prognoses of patients with cardiac arrest, especially out-of-hospital arrest, remain dismal. Clearly, much study into the prevention and treatment of sudden cardiac death is desperately needed.
Herrmann
D J
DJ
Raehl
C L
CL
D000328:Adult; D000465:Algorithms; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002985:Clinical Protocols; D003422:Critical Care; D006323:Heart Arrest / Q000188:drug therapy* / Q000209:etiology / Q000451:nursing; D006801:Humans; D012151:Resuscitation / Q000379:methods*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D000889:Anti-Arrhythmia Agents; D014662:Vasoconstrictor Agents