Vasopressin Saves Lives After Heart Attacks

The survival rate for patients with asystole, the most lethal form of cardiac arrest, has been found to be greatly improved if patients receive an injection of vasopressin (e.g., Pitressin®, King), according to a new study from Europe. A naturally occurring hormone in the human body, vasopressin is a common therapy for frequent urination because of its effect on the kidneys.

In the study, vasopressin was superior to epinephrine in patients whose heart had stopped beating. Patients with asystole cardiac arrest had triple the survival rate when they were given an injection of vasopressin rather than epinephrine, the most common form of treatment in these cases.

Only four of the 262 patients (1.5%) who received epinephrine were eventually able to leave the hospital, whereas 12% of 258 patients (4.7%) who received vasopressin were discharged. Because the long-term survival of patients in cardiac arrest is very poor, the gain from 1.5% to 4.7% is considered significant.
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The patients who received vasopressin were also 40% more likely to reach the hospital alive than those who received epinephrine. The American Heart Association estimates that more than 95% of cardiac arrest patients die before reaching the hospital.

The effects of vasopressin were simi­lar to those of epinephrine in the management of ventricular fibrillation and pulseless electrical activity; however, vasopressin was superior in patients with asystole. The researchers suggested that vasopressin followed by epinephrine might be more effective than epineph-rine alone in cases of refractory cardiac arrest. The results have been so impressive that meetings are scheduled to be held to determine whether resuscitation guidelines should be quickly revised to include the use of vasopressin.