Bibliographic Details
| Title: |
Outcomes associated with amiodarone and lidocaine for the treatment of adult in-hospital cardiac arrest with shock-refractory pulseless ventricular tachyarrhythmia |
| Authors: |
Chih-Hung Wang, Wei-Tien Chang, Chien-Hua Huang, Min-Shan Tsai, Ping-Hsun Yu, Yen-Wen Wu, Yen-Bin Liu, Wen-Jone Chen |
| Source: |
Journal of the Formosan Medical Association, Vol 119, Iss 1, Pp 327-334 (2020) |
| Publisher Information: |
Elsevier, 2020. |
| Publication Year: |
2020 |
| Collection: |
LCC:Medicine (General) |
| Subject Terms: |
Medicine (General), R5-920 |
| More Details: |
Background: To determine the association between amiodarone or lidocaine and outcomes in adult in-hospital cardiac arrest (IHCA) with shock-refractory ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT). Methods: A retrospective study in a single medical centre was conducted. Patients experiencing an IHCA between 2006 and 2015 were screened. Shock-refractory ventricular tachyarrhythmias were defined as VF/pVT requiring more than one defibrillation attempt. A multivariate logistic regression analysis was used to study the associations between the independent variables and outcomes. Results: A total of 130 patients were included. Among these, 113 patients (86.9%) were administered amiodarone as the first antiarrhythmic agent (amiodarone first) following VF/pVT, and the other patients were administered lidocaine (lidocaine first). The median time to the first defibrillation and first antiarrhythmic drug administration were 2 and 9 min, respectively. The analysis demonstrated that the amiodarone-first group experienced a higher likelihood of terminating the VF/pVT within three shocks (odds ratio: 11.61, 95% confidence interval: 1.34–100.84; p-value = 0.03), as compared with the lidocaine-first group. However, there were no significant differences between the amiodarone- and lidocaine-first groups in sustained return of spontaneous circulation, survival for 24 h, survival, or favourable neurological outcomes at hospital discharge. Conclusion: For patients with IHCA and shock-refractory VF/pVT, the adoption of an amiodarone-first strategy seemed to be associated with the termination of VF/pVT using fewer shocks. Nonetheless, because of the small sample size, additional large-scale studies should be conducted to investigate whether this advantage could be translated into a long-term benefit in survival or neurological outcomes. Keywords: Amiodarone, Arrhythmia, Cardiopulmonary resuscitation, In-hospital cardiac arrest, Lidocaine |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
0929-6646 |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S0929664618307538; https://doaj.org/toc/0929-6646 |
| DOI: |
10.1016/j.jfma.2019.05.023 |
| Access URL: |
https://doaj.org/article/f8f1a7d48f92418f86f25d8abe1f54f2 |
| Accession Number: |
edsdoj.f8f1a7d48f92418f86f25d8abe1f54f2 |
| Database: |
Directory of Open Access Journals |
