Upstate EM Residents
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)