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Combo Therapy Provides No Extra Benefit in Cardiac Arrest

Outcomes are the same with combination of vasopressin and epinephrine, or epinephrine alone

WEDNESDAY, July 2 (HealthDay News) -- In patients with out-of-hospital cardiac arrest who receive advanced life support, the administration of vasopressin and epinephrine does not improve outcomes compared to administration of epinephrine alone, according to the results of a study published in the July 3 issue of the New England Journal of Medicine.

Pierre-Yves Gueugniaud, M.D., Ph.D., of the University of Lyon in France, and colleagues randomly assigned 2,894 patients to receive either a combination of epinephrine and vasopressin or epinephrine alone.

The researchers found that there were no significant group differences in survival to hospital admission (20.7 percent for the combination-therapy group versus 21.3 percent for the epinephrine-alone group). They also found no significant group differences in the relative risk of death, return of spontaneous circulation, survival to hospital discharge, one-year survival, or acceptable neurologic recovery at hospital discharge.

"Unfortunately, the small number of patients with ventricular fibrillation in our study precludes a definitive conclusion against the use of vasopressin, even though a weak trend toward better outcomes with epinephrine alone was observed," the authors write. "The only cardiopulmonary-resuscitation interventions that have been proved to increase survival are rapid defibrillation and aggressive chest compression, both of which are performed during basic but not advanced cardiac life support."

One study author reports receiving a grant from Boehringer Ingelheim.

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