Beneficial effects of vasopressin in prolonged pediatric cardiac arrest: a case series

被引:45
作者
Mann, K
Berg, RA
Nadkarni, V
机构
[1] Thomas Jefferson Univ, Sch Med, Dept Pediat, AI DuPont Hosp Children, Wilmington, DE 19899 USA
[2] Univ Arizona, Coll Med, Steele Mem Childrens Res Ctr, Tucson, AZ 85724 USA
[3] AI DuPont Hosp Children, Dept Pediat, Thomas Jefferson Sch Med, Dept Anesthesia & Crit Care, Wilmington, DE 19899 USA
关键词
vasopressin; resuscitation; cardiac arrest; cardiopulmonary resuscitation (CPR); children; pediatric; epinephrine; vasopressor therapy;
D O I
10.1016/S0300-9572(01)00470-1
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Children who suffer cardiac arrest have a poor prognosis. Based on laboratory animal studies and clinical data in adults, vasopressin is an exciting new vasopressor treatment modality during cardiopulmonary resuscitation (CPR). In particular, vasopressin has resulted in short term resuscitation benefits as a 'rescue' pressor agent in the setting of prolonged out-of-hospital CPR for ventricular fibrillation in adults. This retrospective series presents the first evidence for resuscitation benefit of bolus vasopressin therapy in the specific setting of pediatric cardiac arrest. All episodes of CPR initiated in a 120-bed tertiary care children's hospital over a three-year period (1997-2000) were reviewed. Four children in the pediatric ICU received vasopressin boluses as rescue therapy during six cardiac arrest events, following failure of conventional CPR, advanced life support, and epinephrine vasopressor therapy. Return of spontaneous circulation for greater than 60 min occurred in three of four patients (75%) and in four of six CPR events (66%) following vasopressin administration. Two of four vasopressin recipients survived > 24 h; one survived to hospital discharge and one had withdrawal of supportive therapies following family discussion. Our observations are AHA level 5 (retrospective case series) evidence that vasopressin administration may be beneficial during prolonged pediatric cardiac arrest. Such reports should pave the way for prospective clinical trials comparing vasopressor medications in the setting of pediatric cardiac arrest. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:149 / 156
页数:8
相关论文
共 34 条
  • [21] Vasopressin versus epinephrine for inhospital cardiac arrest:: a randomised controlled trial
    Stiell, IG
    Hébert, PC
    Wells, GA
    Vandemheen, KL
    Tang, ASL
    Higginson, LAJ
    Dreyer, JF
    Clement, C
    Battram, E
    Watpool, I
    Mason, S
    Klassen, T
    Weitzman, BN
    [J]. LANCET, 2001, 358 (9276) : 105 - 109
  • [22] Utstein style reporting of in-hospital paediatric cardiopulmonary resuscitation
    Suominen, P
    Olkkola, KT
    Voipio, V
    Korpela, R
    Palo, R
    Räsänen, J
    [J]. RESUSCITATION, 2000, 45 (01) : 17 - 25
  • [23] Pharmacology of pediatric resuscitation
    Ushay, HM
    Notterman, DA
    [J]. PEDIATRIC CLINICS OF NORTH AMERICA, 1997, 44 (01) : 207 - &
  • [24] VOELCKEL W, 2000, CRIT CARE MED A, V68, P28
  • [25] Comparison of epinephrine and vasopressin in a pediatric porcine model of asphyxial cardiac arrest
    Voelckel, WG
    Lurie, KG
    McKnite, S
    Zielinski, T
    Lindstrom, P
    Peterson, C
    Krismer, AC
    Lindner, KH
    Wenzel, V
    [J]. CRITICAL CARE MEDICINE, 2000, 28 (12) : 3777 - 3783
  • [26] Vasopressin improves survival after cardiac arrest in hypovolemic shock
    Voelckel, WG
    Lurie, KG
    Lindner, KH
    Zielinski, T
    McKnite, S
    Krismer, AC
    Wenzel, V
    [J]. ANESTHESIA AND ANALGESIA, 2000, 91 (03) : 627 - 634
  • [27] Survival with full neurologic recovery and no cerebral pathology after prolonged cardiopulmonary resuscitation with vasopressin in pigs
    Wenzel, V
    Lindner, KH
    Krismer, AC
    Voelckel, WG
    Schocke, MF
    Hund, W
    Witkiewicz, M
    Miller, EA
    Klima, G
    Wissel, J
    Lingnau, W
    Aichner, FT
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 35 (02) : 527 - 533
  • [28] Endobronchial vasopressin improves survival during cardiopulmonary resuscitation in pigs
    Wenzel, V
    Lindner, KH
    Prengel, AW
    Lurie, KG
    Strohmenger, HU
    [J]. ANESTHESIOLOGY, 1997, 86 (06) : 1375 - 1381
  • [29] Intraosseous vasopressin improves coronary perfusion pressure rapidly during cardiopulmonary resuscitation in pigs
    Wenzel, V
    Lindner, KH
    Augenstein, S
    Voelckel, W
    Strohmenger, HU
    Prengel, AW
    Steinbach, G
    [J]. CRITICAL CARE MEDICINE, 1999, 27 (08) : 1565 - 1569
  • [30] Vasopressin improves vital organ blood flow after prolonged cardiac arrest with postcountershock pulseless electrical activity in pigs
    Wenzel, V
    Lindner, KH
    Prengel, AW
    Maier, C
    Voelckel, W
    Lurie, KG
    Strohmenger, HU
    [J]. CRITICAL CARE MEDICINE, 1999, 27 (03) : 486 - 492