Pressor drugs in the treatment of cardiac arrest.
The importance of vital organ perfusion in patients suffering cardiac arrest makes arterial vasomotor tone, and the resultant perfusion pressure, critical in resuscitation from sudden death. Although there are multiple mechanisms that may affect arterial vascular tone, historically, the therapy most commonly used has been catecholamine-induced adrenergic receptor stimulation, with catecholamine epinephrine being the commonest drug used. Over the last decade, however, it has become widely known that the utility of epinephrine during cardiopulmonary resuscitation is undefined. This has led to research into alternative agents, in particular nonadrenergic vasoactive peptides. Other agents appear promising. This article addresses pressor drugs and adrenergic agonists, including a review of their history, basic science, mechanism of action, and efficacy. Epinephrine is reviewed.
Paradis
Norman A
NA
Section of Emergency Medicine, Departments of Surgery and Medicine, University of Colorado Health Sciences Center, Denver, Colorado, USA. Norman.Paradis@UCHSC.edu
Wenzel
Volker
V
Southall
John
J
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004837:Epinephrine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects; D014667:Vasopressins / Q000008:administration & dosage* / Q000009:adverse effects
D000318:Adrenergic beta-Agonists; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D004837:Epinephrine