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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