Episode 913: Vasopressors after ROSC

Emergency Medical Minute

Contributor: Travis Barlock MD

Educational Pearls:

• Recent study assessed outcomes after ROSC with epinephrine vs. norepinephrine

• Observational multicenter study from 2011-2018

• 285 patients received epineprhine and 481 received norepinephrine

• Epinephrine was associated with an increase in all-cause mortality (primary outcome)

• Odds ratio 2.6; 95%CI 1.4-4.7; P = 0.002

• Higher cardiovascular mortality (secondary outcome)

• Higher proportion of unfavorable neurological outcome (secondary outcome)

• Norepinephrine is the vasopressor of choice in post-cardiac arrest care

References

1. Bougouin W, Slimani K, Renaudier M, et al. Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock. Intensive Care Med. 2022;48(3):300-310. doi:10.1007/s00134-021-06608-7

Summarized by Jorge Chalit, OMSIII | Edited by Meg Joyce & Jorge Chalit