Abstract:
BACKGROUND:Successful outcomes after cardiopulmonary resuscitation remain disappointingly infrequent, in animal studies, administration of exogenous vasopressin during closed- and open-chest cardiopulmonary resuscitation has recently been shown to be more effective than optimal doses of epinephrine in improving vital organ blood flow. OBJECTIVE:To describe the clinical effects and outcomes of administering vasopressin to patients in cardiac arrest refractory to current medical therapies. DESIGN:Case reports. SETTING:University hospital. PATIENTS:8 adults with in-hospital cardiac arrest. INTERVENTIONS:After intravenous epinephrine (administered according to American Heart Association guidelines) and defibrillation efforts had failed, patients in cardiac arrest who were having cardiopulmonary resuscitation received 40 U of vasopressin intravenously and then defibrillation. MEASUREMENTS:Return of spontaneous circulation and hospital discharge rates. RESULTS:After administration of vasopressin, spontaneous circulation was promptly restored in all patients. Three patients were discharged from the hospital with intact neurologic function; the other five lived for between 30 minutes and 82 hours. CONCLUSION:In the presence of ventricular fibrillation with severe hypoxia and acidosis, vasopressin seems to be more potent and effective than adrenergic vasopressors for restoring spontaneous cardiovascular function. These results do not justify the widespread use of vasopressin for refractory cardiac arrest. However, on the basis of these cases, further studies comparing vasopressin with epinephrine are warranted in an effort to improve the currently dismal prognosis of patients after cardiac arrest.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Lindner KH,Prengel AW,Brinkmann A,Strohmenger HU,Lindner IM,Lurie KGdoi
10.7326/0003-4819-124-12-199606150-00006subject
Has Abstractpub_date
1996-06-15 00:00:00pages
1061-4issue
12eissn
0003-4819issn
1539-3704journal_volume
124pub_type
杂志文章abstract::Since 1969, medications have been provided to patients at the Johns Hopkins Hospital using a computer system that controls the entire medication process from entry of physician's order to hourly drug distribution. Special envelopes containing patient and dosage information are computer generated for each dose to be ad...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-3-342
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journal_title:Annals of internal medicine
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doi:10.7326/0003-4819-130-10-199905180-00004
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abstract::From 1969 to 1974, 19 cases of Serratia marcescens endocarditis were observed in the San Francisco Bay Area. Seventeen patients were intravenous drug users, and Serratia caused 14% of all addict-associated endocarditis in San Francisco. Serratia strains were nonpigmented and had typical antibiotic sensitivities, excep...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-1-29
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abstract::The relation of menopause to cardiovascular disease incidence was examined in women less than 55 years old from the cohort of 2873 women in the initial Framingham examination. Although the number of person-years of experience during the 20 years of observation was nearly the same for premenopausal and postmenopausal s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-4-447
更新日期:1976-10-01 00:00:00
abstract::Tissues from guinea pigs inoculated intraperitoneally with the Legionnaires' disease (LD) bacterium were studied with light, immunofluorescent, and electron microscopy. The principal gross lesion was diffuse peritonitis of varying severity. Microscopically, the peritonitis of covered by a mixed inflammatory infiltrate...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-4-671
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abstract:BACKGROUND:Warfarin reduces the risk for ischemic stroke in patients with atrial fibrillation (AF) but increases the risk for hemorrhage. Dabigatran is a fixed-dose, oral direct thrombin inhibitor with similar or reduced rates of ischemic stroke and intracranial hemorrhage in patients with AF compared with those of war...
journal_title:Annals of internal medicine
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doi:10.7326/0003-4819-154-1-201101040-00289
更新日期:2011-01-04 00:00:00
abstract::Of 476 patients with multiple myeloma treated during a 9-year period, 11 developed acute myelogenous leukemia or sideroblastic anemia. In all, the myeloma was in remission from chemotherapy with melphalan-prednisone combinations that had been continued for a median duration of 3 years. The incidence of acute leukemia ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-4-440
更新日期:1977-04-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-90-2-219
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:Previous research has supported screening for gonorrhea and chlamydia in asymptomatic, sexually active women (including pregnant women) who are younger than 25 years or at increased risk but not in other patient populations. PURPOSE:To update the 2005 and 2007 systematic reviews for the U.S. Preventive Serv...
journal_title:Annals of internal medicine
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journal_title:Annals of internal medicine
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更新日期:1989-10-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2005-07-05 00:00:00
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更新日期:2008-03-18 00:00:00
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journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,评审
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abstract::Young adults with cystic fibrosis have lower blood pressures than control subjects of similar age and sex. The low blood pressure may be related to the excessive loss of salt in the sweat of these patients. A beneficial effect of the cystic fibrosis gene may be protection against developing hypertension in both the ho...
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-116-10-806
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更新日期:2015-11-17 00:00:00
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pub_type: 杂志文章,评审
doi:10.7326/0003-4819-116-12-1009
更新日期:1992-06-15 00:00:00
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journal_title:Annals of internal medicine
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更新日期:1986-08-01 00:00:00
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doi:10.7326/0003-4819-122-4-199502150-00003
更新日期:1995-02-15 00:00:00
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journal_title:Annals of internal medicine
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更新日期:1985-12-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章
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更新日期:1991-04-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-2-243
更新日期:1980-02-01 00:00:00
abstract::In an era of increasing competition in medical care, critical pathway guidelines have emerged as one of the most popular new initiatives intended to reduce costs while maintaining or even improving the quality of care. Developed primarily for high-volume hospital diagnoses, critical pathways display goals for patients...
journal_title:Annals of internal medicine
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更新日期:1995-12-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1980-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of a human immunodeficiency virus (HIV) vaccine given to uninfected volunteers on the interpretation of serodiagnostic HIV test results. DESIGN:Retrospective cohort study. SETTING:5 AIDS Vaccine Evaluation Units funded by the National Institute of Allergy and Infectious Diseases. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-121-8-199410150-00005
更新日期:1994-10-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-133-2-200007180-00013
更新日期:2000-07-18 00:00:00