Vasopressin & Methylprednisolone: Time to Add Them to ACLS Protocols?

A new study is showing that we should add vasopressin and methylprednisolone to our ACLS protocols as it helps patients achieve ROSC faster. Should they be standard of care? In this episode, we discuss the use of vasopressin and methylprednisolone in cardiac arrest and their potential benefits. We explore the studies that have examined the use of these medications in ACLS protocols and their mechanisms of action. We also review the controversies surrounding their use, including the lack of strong evidence and potential adverse effects. Join us as we weigh the pros and cons of incorporating these drugs into our resuscitation strategies.

Show Notes: https://eddyjoemd.com/vasopressin-methylprednisolone/

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Citations:

Andersen LW, Isbye D, Kjærgaard J, Kristensen CM, Darling S, Zwisler ST, Fisker S, Schmidt JC, Kirkegaard H, Grejs AM, Rossau JRG, Larsen JM, Rasmussen BS, Riddersholm S, Iversen K, Schultz M, Nielsen JL, Løfgren B, Lauridsen KG, Sølling C, Pælestik K, Kjærgaard AG, Due-Rasmussen D, Folke F, Charlot MG, Jepsen RMHG, Wiberg S, Donnino M, Kurth T, Høybye M, Sindberg B, Holmberg MJ, Granfeldt A. 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 Oct 26;326(16):1586-1594. doi: 10.1001/jama.2021.16628. PMID: 34587236; PMCID: PMC8482303.  

Haukoos J, Douglas IS, Sasson C. Vasopressin and Steroids as Adjunctive Treatment for In-Hospital Cardiac Arrest. JAMA. 2021 Oct 26;326(16):1583-1585. doi: 10.1001/jama.2021.15460. Erratum in: JAMA. 2021 Nov 9;326(18):1874. PMID: 34587235.  

Holmberg MJ, Granfeldt A, Mentzelopoulos SD, Andersen LW. Vasopressin and glucocorticoids for in-hospital cardiac arrest: A systematic review and meta-analysis of individual participant data. Resuscitation. 2022 Jan 3;171:48-56. doi: 10.1016/j.resuscitation.2021.12.030. Epub ahead of print. PMID: 34990764.

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