Efficacy of vasopressin combined with epinephrine during adult cardiopulmonary resuscitation:a meta-analysis
ZOU Qin-hua
QIAN Hui-yin
XU Bo
ZHU Jian-liang
ZHOU Bao-chun
LIU Yi-wei
ZHU Ling-xia
LIU Li-jun
Abstract：Objective During adult cardiopulmonary resuscitation, the efficacy of vasopressin combined with epinephrine versus epinephrine alone remains controversial. This meta - analysis was conducted on the existing clinical research data. Methods PubMed and WANFANG databases were searched for randomized controlled clinical studies on the combination or the use of epinephrine alone during adult cardiopulmonary resuscitation. The observation outcomes included the return of spontaneous circulation (ROSC) after cardiopulmonary resuscitation, admission survival (short -term survival), discharge survival ( long - term survival ) and neurological prognosis. Results Eight randomized controlled trials (5740 patients) from 191 retrieved articles were included in the analysis, of which five articles (5172 patients) were on out-of-hospital cardiac arrest and three articles (568 patients) on in-hospital cardiac arrest. Subgroup analysis were conducted based on the initial rhythm into ventricular fibrillation, pulse-less electrical activity and asystole. The Results showed that when compared with epinephrine alone ( epinephrine group) , the combination of vasopressin and epinephrine ( vasopressin +epinephrine group) could improve the rate of short-term survival during cardiac arrest in adult patients (RR=1. 15, 95% CI=1. 01 ~1. 32,P=0. 04),but not the rates of the ROSC, long-term survival and neurological prognosis. However, according to subgroup analysis, vasopressin + epinephrine group vs. epinephrine group was associated with higher ROSC ( RR =1. 30, 95% CI =1. 11 ~1. 51, P =0.001)and short-term survival (RR =1. 23, 95% CI =1. 05 ~1. 44, P =0. 01) in in -hospital patients with cardiac arrest. Conclusion In cardiac arrest patients, vasopressin combined with epinephrine can significantly improve the short - term survival versus epinephrine alone. Also, the combined use of vasopressin and epinephrine may improve the ROSC and short-term survival in in-hospital patients with cardiac arrest.
Keywords：Cardiopulmonary resuscitation(CPR)Cardiac arrest(CA)EpinephrineVasopressinMeta-analysis
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 539-546 )