Vasopressin vs. Epinephrine in Treatment of Sudden Cardiac Arrest

Vasopressin vs. Epinephrine in Treatment of Sudden Cardiac Arrest

Mackenzie Thompson

by Mackenzie Thompson

Life Saver, AMC

posted on Aug 17, 2014, at 9:49 pm


DRUGS THAT CAUSE THE CONTRACTION OF BLOOD VESSELS, or vasopressors, are necessary for effective Advanced Cardiac Life Support (ACLS). If your patient unfortunately has respiratory and/or metabolic acidosis, the vascular constrictive characteristics of epinephrine, a regularly administered ACLS agent, could potentially be blunted. Epinephrine is known for increasing heart rate, blood pressure, cardiac output, and carbohydrate metabolism. The combined effects could result in declined survival to hospital discharge. Vasopressin, another standard vasopressor and ACLS drug, has similar properties to epinephrine and can also aid in return of spontaneous circulation (ROSC). Both drugs have frequently been administered incoherently for similar situations of cardiac arrest. How can we, as medical professionals, use both drugs to improve survival rates? How can we increase the effectiveness of ACLS drugs to victims undergoing cardiac arrest?

Enhancing the powerful features of epinephrine and vasopressin begins with a basic understanding of how the drugs work alone. As you may know, it’s vital to have the ability to correctly use and identify the drugs on ACLS algorithms and recall their reactions during situations of cardiac arrest. Epinephrine is an adrenergic agonist, and exerts vasoconstriction by binding to a-receptors in the peripheral vasculature that moves blood to the visceral and cerebral regions. It also binds to ?-receptors, improving the contractile state of the heart, increasing impulsive contractions, and strengthening ventricular fibrillation. All of this advances the probability of successful ROSC. Yet the best dosage of epinephrine remains controversial among medical professionals, which has prompted researchers to seek an alternative vasopressor. This is where vasopressin, which increases peripheral vascular resistance and arterial blood pressure like epinephrine, becomes imperative for ROSC. Vasopressin is critical for restoring appropriate blood pressure.

To establish a better understanding of these drugs in combination, instead of alone, and their association with ROSC, researchers conducted trials. Patients were required to be least 18 years of age with authorized documentation of cardiac arrest. 101 patients needed vasopressor therapy and were conducted in the experiment. The results proved no change in rate of ROSC or survival to hospital discharge. Cardiac arrest patients who received the combination of drugs with initial arterial pH less than 7.2, however, ROSC was improved.

Obviously there is still much to learn about ACLS drug interactions and dosages to increase ROSC, especially because these protocols can be challenging to remember. Therefore, it is essential to have access to organized reference guides and study materials. Develop your career as a medical professional and increase patient rate of survival by studying drug interactions and protocols often, and by referring to references regularly.

About Mackenzie

Mackenzie is a lover of world travel, photography, design, style and Chinese cooking. She is passionate about working towards a purpose, recently graduated from Indiana University with a degree in Media and Marketing, and is currently residing in Manhattan.

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