Cardiovascular Life Support – AHA Guidelines –2000 PHARMACOLOGICAL GUIDELINES
•Vasopressin (arginine vasopressin) may be a more
effective pressor agent thanepinephrine for promoting the return of spontaneous
circulation in cardiac arrest.
Theevidence from prospective clinical
trials in humans is limited but consistently
positive(Class IIb). Vasopressin
(40 U IV, not repeated) may be substituted
for epinephrine as analternative
Class IIb agent. The lower adverse
effects profile may be the major indicationfor vasopressin.
•Research on high-dose epinephrine has not yet shown
that routine use of initial andrepeated or escalating doses of
epinephrine can improve survival in cardiac
arrest Nor has high-dose epinephrine (0.1 mg/kg) in adults been shown toimprove
survival or neurological outcomes.
•Cardiac arrest survivors who received high-dose
epinephrine have more postresuscitationcomplications than survivors who received
the standard dose.
•Because of the potential forharm, high-dose epinephrine (0.1 mg/kg) is