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About 80% of patients with in-hospital cardiac arrest do not survive to hospital discharge, and the mortality rate is even higher in patients with refractory arrest. These authors hypothesized that adding treatment with vasopressin (for its effects on vascular tone) and corticosteroids (for their effect on systemic inflammatory response and organ dysfunction) to standard treatment with epinephrine would improve outcomes after in-hospital cardiac arrest.
In a European single-center, randomized, double-blind, placebo-controlled study, researchers enrolled 100 consecutive patients from various areas of the hospital, including the emergency department, who had refractory cardiac arrest (defined as asystole/pulseless electrical activity or arrest…