Vasopresina mai eficace decat adrenalina, la pacientii cu asistolie
Un ghid international referitor la resuscitarea cardio-pulmonara recomanda uzul adrenalinei, considerand vasopresina o alternativa. Cercetatorii Universitatii "Leopold-Franzens" din Innsbruck au confruntat rezultatele tratamentului cu doua injectii de vasopresina (40 UI) si cu a doua injectii de adrenalina (1 mg), la pacientii adulti care aveau un atac cardiac extra-
spitalicesc.
Au luat parte la studiu 1186 pacienti dintre care la 589 li s-a injectat vasopresina si la 597 - adrenalina. La pacientii cu fibrilatie ventriculara nu a fost observata nici o diferenta la in ceea ce priveste supravietuirea la momentul internarii (46,2% dintre pacientii din grupul "vasopresina" si
43% dintre pacientii din grupul "adrenalina").
La pacientii cu asistolie, dimpotriva, procentul de subiecti spitalizati era mult mai mare la grupul "vasopresina" (29%), decat la grupul "adrenalina" (20,3%). Pe langa aceasta, procentul pacientilor supravietuitori la momentul
externarii, este mai mare la primul grup, 4,7% versus 1,5%.
Pacientii la care circulatia sanguina nu era stabilizata cu acele doua injectii, tratamentul adjuvant cu adrenalina a produs o ameliorare semnificativa a procentului supravietuitorilor la grupul "vasopresina", dar nu si la celalalt grup (25,7% versus 16,4% - in momentul externarii, 6,2 versus 1,7% - in momentul spitalizarii).
Astfel, vasopresina a dat rezultate superioare tratamentului cu adrenalina, la pacientii cu asistolie, asocierea celor doua medicamente fiind mult mai eficace decat administrarea numai de adrenalina, in tratamentul infarctului. (Wenzel V. et al, N Engl J Med 2004)
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