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المستخلص
AHA released revised guidelines for CPR and emergency cardiovascular care. The consensus was that, vasopressors should remain a part of pulseless sudden cardiac arrest management, with epinephrine 1 mg every 3-5 minutes being the recommended adrenergic of choice. In the revised guidelines, the role of vasopressin expanded beyond previous recommendations, despite the recommendation being downgraded to class indeterminate.
• The guidelines comment that one dose of vasopressin (40 units I.V) may replace the first or second dose of epinephrine in all pulseless sudden cardiac arrest.
• Clinical reports and experimental studies certainly support the beneficial effects of low-dose vasopressin infusions in vasodilatory shock. Nevertheless, no clinical study has yet demonstrated reduced mortality in patients treated with vasopressin.
• ”Renal dose” dopamine: Dopamine selectively increases renal blood flow when administered to normal volunteers at 1-3ug/kg/minute. However, a beneficial effect of low or ”renal dose” dopamine is less proven in human patients with sepsis or other critical illness.