Podcast 769: Pressors After Cardiac Arrest

<strong>Contributor: Aaron Lessen, MD</strong> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Hypotension after cardiac arrest often requires a vasopressor to improve blood pressure</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Recent observational study from France examined outcomes of patients who received either epinephrine or norepinephrine for post-resuscitation shock</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Norepinephrine had significantly better outcomes </span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Death from shock was 35% in the epinephrine group vs. 9% in the norepinephrine group</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Recurrent cardiac arrest was 9% in epinephrine group vs. 3% in norepinephrine group</span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">For epinephrine:</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">The all cause mortality was 2.5 times higher than norepinephrine</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Cardiovascular mortality was 5 times higher than norepinephrine</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Favorable neurological outcomes was 3 times worse than norepinephrine</span></li> </ul> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Bougouin W, Slimani K, Renaudier M, Binois Y, Paul M, Dumas F, Lamhaut L, Loeb T, Ortuno S, Deye N, Voicu S, Beganton F, Jost D, Mekontso-Dessap A, Marijon E, Jouven X, Aissaoui N, Cariou A; Sudden Death Expertise Center Investigators. Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock. Intensive Care Med. 2022 Mar;48(3):300-310. d