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On the 8th of this month, the large mutlicentre European Resuscitation Council study comparing the effects of adrenaline and vasopressin in out of hospital cardiac arrest was published. This was a mutlicentre study conducted between 1999 and 2002 in Austria, Germany, and Switzerland. Patients with an out of hospital cardiac arrest requiring cardiopulmonary resuscitation and intravenous vasopressor therapy were included. The study shows no statistically significant benefit in primary (overall survival to hospital) or secondary (overall survival to discharge) end points. A subset analysis demonstrated that more patients in asystolic arrest survived to hospital after the administration of vasopressin as compared with adrenaline. Notably, the survival to discharge did not reach clinical significance. The sub-analysis further showed that of those who did not respond to two doses of research drug and went on to be given adrenaline, significantly more patients in the vasopressin group reached both end points.
This is the largest study addressing the question whether vasopressin should be used in an arrest. As normal practice, the Best BET comparing these two entities has been updated to include this evidence.
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