Effectiveness of Vasopressin Against Cardiac Arrest: A Systematic Review of Systematic Reviews.
Cardiovascular Drugs and Therapy · 2024-03-12 · Systematic review
Abstract
PURPOSE: This systematic review (SR) of SRs evaluates the effectiveness of vasopressin alone or in combination with other drugs in improving the outcomes of cardiac arrest (CA). METHODS: Using a three-step approach, we searched five databases to identify all relevant SRs. Two reviewers independently selected suitable studies, assessed study quality, and extracted relevant data. If an outcome was reported by multiple SRs, a re-meta-analysis was conducted as needed; otherwise, a narrative analysis was performed. RESULTS: Twelve SRs covering 16 original studies were included in this review. The meta-analysis results revealed a significant increase in survival to hospital admission for patients with in-hospital CA (IHCA) or out-of-hospital CA (OHCA) receiving vasopressin alone compared with that for those receiving epinephrine alone. Furthermore, the return of spontaneous circulation (ROSC) was significantly increased in patients with OHCA receiving vasopressin with epinephrine compared with that in those receiving epinephrine alone. Compared with patients with IHCA receiving epinephrine with placebo, those receiving vasopressin, steroids, and epinephrine (VSE) exhibited significant increases in ROSC, survival to hospital discharge, favorable neurological outcomes, mean arterial pressure, renal failure-free days, coagulation failure-free days, and insulin requirement. CONCLUSION: VSE is the most effective drug combination for improving the short- and long-term outcomes of IHCA. It is recommended to use VSE in patients with IHCA. Future studies should investigate the effectiveness of VSE against OHCA and CA of various etiologies, the types and standard dosages of steroids for cardiac resuscitation, and the effectiveness of vasopressin-steroid in improving CA outcomes.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Adrenaline · Cardiovascular drugs · Mortality & survival · Quality of life & function · Vasopressin
Related articles
- Comparative Efficacy and Safety of Intravenous Vasopressors in Pre-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis. (J Emerg Med, 2025)
- Comparison of different treatments of out-of-hospital cardiac arrest: A systematic review and network meta-analysis. (Medicine (Baltimore), 2025)
- Epinephrine in Out-of-Hospital Cardiac Arrest: A Network Meta-analysis and Subgroup Analyses of Shockable and Nonshockable Rhythms. (Chest, 2023)
- Use of Corticosteroids in Cardiac Arrest-A Systematic Review and Meta-Analysis. (Crit Care Med, 2021)
- Epinephrine for Out-of-Hospital Cardiac Arrest: An Updated Systematic Review and Meta-Analysis. (Crit Care Med, 2020)
- Vasopressors during adult cardiac arrest: A systematic review and meta-analysis. (Resuscitation, 2019)