Date sent: Wed, 22 Nov 1995 01:15:08 -0600 (CST) From: Harvey Louzon To: emed-l@itsa.ucsf.edu Subject: emed-l amiodarone in cardiac arrest The FDA has recently approved the use of amiodarone for refractory ventricular fibrillation and VT. Case reports of patients given amiodarone after failure of prolonged resusitative therapy with good outcome have appeared sporadically in the literature for several years (1,2). After reviewing the literature of pharacotherpy for cardiac arrest and noting the dismal prognosis and lack of demonstrated efficacy of most drugs, the European Resusitation Council observed that "...most drug therapy is inappropriate during resusitation." (3) and urged further large scale studies (of amiodarone and other drugs) in this setting. A retrospective study done in the U.S. (4) looked at patients who had been given IV amiodarone after prolonged resusitation attempts after conventional treatment had failed. Fourteen patients recieved it an average of 75 minutes into the resusitation effort. After an infusion of from 150 to 600 mg (with a repeat dose of from 150 to 450 mg in 7 patients) the short term survival rate was 79% (11/14). Eight out of 14 (57%) survived to hospital discharge. The more I read about it--the more I like it. H. Louzon MD (1) Massive Digoxin Overdose: Successful Treatment with Intravenous Amiodarone. Maheswaran et. al. Br Med J 1983 287:392-393 (2) Intravenous Amiodarone in Ventricular Fibrillation. Chapman et. al. Br Med J 1981 282:951-952 (3) Drug Treatment of Arrhythmias During Cardiopulmonary Resusitation: A Statement of the Advanced Life Support Working Party of the European Resusitation Council. Resusitation 24 (1992) 227-232 (4) Intravenous Amiodarone During Prolonged Resusitation from Cardiac Arrest. Williams et. al. Ann Int Med 1989;11:839-842 =*=*=*=*=*=*=*=*=*= To remove yourself from emed-l send mail to majordomo@itssrv1.ucsf.edu with 'unsubscribe emed-l' in the body of the message.