Emergency Medical Minute4 Apr 2022

Podcast 769: Pressors After Cardiac Arrest

Contributor: Aaron Lessen, MD

Educational Pearls:

Hypotension after cardiac arrest often requires a vasopressor to improve blood pressure
Recent observational study from France examined outcomes of patients who received either epinephrine or norepinephrine for post-resuscitation shock
Norepinephrine had significantly better outcomes

Death from shock was 35% in the epinephrine group vs. 9% in the norepinephrine group
Recurrent cardiac arrest was 9% in epinephrine group vs. 3% in norepinephrine group

For epinephrine:

The all cause mortality was 2.5 times higher than norepinephrine
Cardiovascular mortality was 5 times higher than norepinephrine
Favorable neurological outcomes was 3 times worse than norepinephrine

References

Bougouin W, Slimani K, Renaudier M, Binois Y, Paul M, Dumas F, Lamhaut L, Loeb T, Ortuno S, Deye N, Voicu S, Beganton F, Jost D, Mekontso-Dessap A, Marijon E, Jouven X, Aissaoui N, Cariou A; Sudden Death Expertise Center Investigators. Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock. Intensive Care Med. 2022 Mar;48(3):300-310. doi: 10.1007/s00134-021-06608-7. Epub 2022 Feb 7. PMID: 35129643.

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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