A Comparison of Vasopressin and Epinephrine for Out-of-Hospital Cardiopulmonary Resuscitation

Epinephrine is recommended for use in the resuscitation of patients with cardiac arrest. In this clinical trial, vasopressin, as compared with epinephrine, improved the rates of survival to hospital admission and discharge, but only among patients with asystolic cardiac arrest. There was no advantage to vasopressin therapy in patients with ventricular fibrillation or pulseless electrical activity. As compared with epinephrine, improved the rates of survival to hospital admission. There are more than 600,000 sudden deaths in North America and Europe each year. More than half of these deaths occur before 65 years of age, which underscores the need for optimal cardiopulmonary resuscitation (CPR) strategies in order to improve patients' chances of survival. Epinephrine has been used during CPR for more than 100 years 1 but has become controversial because it is associated with increased myocardial oxygen consumption, ventricular arrhythmias, and myocardial dysfunction during the period after resuscitation. 2 Since it was found that endogenous vasopressin levels in successfully resuscitated patients were significantly higher than levels in patients who died, it . . .