Vasopressin and endothelin during cardiopulmonary resuscitation

Vital organ blood flow during cardiopulmonary resuscitation (CPR) and neuro logic recovery after CPR were significantly better in pigs treated with vas opressin compared with epinephrine. Furthermore, two clinical studies evalu ating both out-of-hospital and inhospital cardiac arrest patients found hig her 24-hr survival rates in patients who were resuscitated with vasopressin compared with epinephrine. Scientists at the Leopold Franzens University i n Innsbruck, Austria, are currently coordinating a multicenter, randomized clinical trial under the aegis of the European Resuscitation Council to stu dy the effects of vasopressin vs. epinephrine in out-of-hospital cardiac ar rest patients. Results of anticipated 1,500 enrolled patients may be availa ble in 2001 and may help to determine the role of vasopressin during CPR, A nother new, recently studied vasopressor for CPR is endothelin-l, To date, this vasopressor has only been studied as an intervention in animal CPR mod els, although plasma levels have been investigated in cardiac arrest patien ts. Initial reports found improved coronary perfusion pressure when combine d with epinephrine, However, the CPR research group of the University of Ar izona Sarver Heart Center found excessive vasoconstriction and worse surviv al than with epinephrine alone.