ADENOSINE RECEPTOR ANTAGONISM IN REFRACTORY ASYSTOLIC CARDIAC-ARREST - RESULTS OF A HUMAN PILOT-STUDY

Primary objective: To determine if adenosine receptor antagonism has a ny beneficial impact on victims of asystolic cardiac arrest and whethe r or not it warrants further clinical study as a treatment for cardiac asystole. Materials and Methods: A 6-month prospective, randomized, d ouble-blinded, placebo-controlled trial, set in an urban emergency med ical services system, in adults with nontraumatic asystolic out-of-hos pital cardiac arrest. Patients in whom standard advanced cardiac life support pharmacotherapy failed were randomized to receive placebo or a minophylline, a nonspecific competitive adenosine receptor antagonist. Rhythms were recorded before and after intervention. Results: Twenty- two patients were appropriately entered into the trial. Eight patients served as controls and 14 patients received aminophylline. The groups were similar in all measured parameters except for initial rhythm. No ne of the patients in the placebo group responded to the intervention. Half of the patients in the treatment group had return of organized c ardiac electrical activity. Conclusion: Our results suggest that adeno sine receptor antagonism may have a role in the treatment of cardiac a systole. Further clinical studies to validate these findings and clari fy the appropriate use of adenosine receptor antagonists in cardiac as ystole may be justified. (C) 1997 Elsevier Science Ireland Ltd.