Role of arginine vasopressin in the setting of cardiopulmonary resuscitation.
Arginine vasopressin (AVP) constitutes an integral part of the neuroendocrine stress response during cardiac arrest. A strong correlation between endogenous AVP secretion and outcome from cardiac arrest has led to a number of experimental studies indicating a survival benefit of AVP compared to epinephrine. In the clinical setting, however, things are less clear. Although current data suggest that both epinephrine and AVP are equally effective to restore spontaneous circulation in out-of-hospital cardiac arrest, benefits of AVP in specific patient groups, e.g. those with asystolic cardiac arrest, have been shown. The latest international guidelines recommend AVP as an alternative vasopressor drug which may replace the first or second dosage of epinephrine in the treatment of pulseless arrest If the combined use of AVP and epinephrine is superior to epinephrine alone in terms of improved hospital admission and discharge rates this needs to be re-confirmed by the results of an ongoing multicenter trial.
Wenzel
Volker
V
Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria. volker.wenzel@uki.at
Raab
Helmut
H
Dünser
Martin W
MW
D000818:Animals; D001127:Arginine Vasopressin / Q000502:physiology / Q000627:therapeutic use*; D016887:Cardiopulmonary Resuscitation; D006323:Heart Arrest / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D001127:Arginine Vasopressin