Defibrillation effects of intravenous nifekalant in patients with out-of-hospital ventricular fibrillation.
Nifekalant (NF), a pure K(+) channel blocker developed in Japan, has been reported to be effective in the treatment of life-threatening ventricular arrhythmias. We studied its efficacy in 18 men and 4 women with out-of-hospital ventricular fibrillation (VF) admitted to our emergency department between August 2001 and March 2004. The number of DC shocks delivered for out-of-hospital VF, serum Na(+) and K(+), arterial blood pH, and base excess were compared in 8 patients treated with NF, 0.3 mg/kg i.v. followed by a continuous intravenous (group N) versus 14 patients treated with lidocaine, 2 mg/kg, i.v. (group C). The two groups were similar with respect to their baseline characteristics. Sinus rhythm returned in 5 of 8 patients in group N versus 2 of 14 patients in group C (P < 0.05). These seven patients were admitted to the intensive care unit, though all died within 1 month. The results of this study suggest that NF may be effective in defibrillation of out-of-hospital VF, though controlled studies are needed to confirm our observations.
Igarashi
Masaki
M
Critical Care Center, Toho Omori University Hospital, Otaku, Tokyo, Japan. masaki50@oak.ocn.ne.jp
Fujino
Tadashi
T
Toyoda
Miwako
M
Sugino
Keishi
K
Sasao
Kenichirou
K
Sasamoto
Shuichi
S
Otsuka
Takayuki
T
Kobayashi
Kenzaburo
K
Okano
Yoshifumi
Y
Yosiwara
Katsunori
K
Koyama
Nobuya
N
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D004554:Electric Countershock; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011744:Pyrimidinones / Q000008:administration & dosage*; D014693:Ventricular Fibrillation / Q000188:drug therapy* / Q000628:therapy
D000889:Anti-Arrhythmia Agents; D011744:Pyrimidinones; C076259:nifekalant