Vasopressin Adds No Benefit to Epinephrine in Cardiac Arrest

Animal studies and small human studies have provided preliminary evidence that adding vasopressin to the standard advanced cardiac life support (ACLS) drug regimen improves survival after cardiac arrest. However, this evidence had not been validated in a large, randomized, placebo-controlled trial.

In a multicenter study, researchers in France randomized 2894 patients with out-of-hospital cardiac arrest to receive epinephrine (1 mg) plus either placebo or vasopressin (40 IU) after three failed attempts at defibrillation. The assigned drug regimen was repeated after 3 minutes if spontaneous circulation was not restored, and open-label epinephrine was administered at the discretion of the treating physician if after another 3 minutes spontaneo…