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Aside from aggressive chest compressions and early defibrillation, robust data are lacking on interventions to improve cardiac arrest outcomes. A small study in 2009 suggested improved surrogate outcomes with use of a vasopressin-steroids-epinephrine (VSE) combination for in-hospital cardiac arrest. These data prompted researchers in Greece to perform a randomized trial involving 300 in-hospital cardiac arrest patients who required at least one dose of epinephrine.
Patients received either VSE (20 units vasopressin and 1 mg epinephrine per 3-minute cycle for up to 5 cycles plus 40 mg methylprednisolone with the first dose of epinephrine) or placebo (saline) plus the standard 1 mg epinephrine dose during each 3-minute cycle. Postresuscitation…