Vasopressin and Methylprednisolone in Cardiac Arrest
Andersen LW, Isbye D, Kjærgaard J, et al. Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2021;326(16):1586–1594. doi:10.1001/jama.2021.16628
Mentzelopoulos SD, Zakynthinos SG, Tzoufi M, Katsios N, Papastylianou A, Gkisioti S, Stathopoulos A, Kollintza A, Stamataki E, Roussos C. Vasopressin, epinephrine, and corticosteroids for in-hospital cardiac arrest. Arch Intern Med. 2009 Jan 12;169(1):15-24. doi: 10.1001/archinternmed.2008.509. PMID: 19139319.
This month we covered both new and old literature regarding the potential utility of vasopressin and methylprednisolone in cardiac arrest. The VAM-ICHA trial was published recently in JAMA and served as a more modern take to a similar approach to vasopressin and methylprednisolone that was examined in 2009 by Mentzelopoulos et al.. In this study the VAM protocol (20U vasopressin and 40mg methylprednisolone every 3-5 minutes up to four doses) was found to have an approximate 20% relative increase in rate of ROSC, but there were no improved long-term neurologic outcomes. Further research into this topic may potentially find specific patient and/or cardiac arrest characteristics that would benefit from treatments similar to this one, but the VAM protocol should remain a consideration in addition to standard ACLS algorithms only.
February Journal Club Discussion Leader: Conor Young, MD (PGY-2)
2021-2022 Academic Year Journal Club Leaders: Rose Solomon, MD (PGY-3); Jarred Worthy, DO (PGY-2); David Andonian, MD (Faculty Advisor)