Title: VF or pulseless VT...just give saline?<br/>Author: Haney Mallemat<br/><a href='http://umem.org/profiles/faculty/785/'>[Click to email author]</a><hr/><ul> <li> Amiodarone and lidocaine are commonly used antiarrhythmics for ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). Their efficacy towards survival to hospital discharge and neurological outcome, however, has been questioned.</li> <li> A recently published study in the <a href="https://www.ncbi.nlm.nih.gov/pubmed/27043165">NEJM</a> evaluated these drugs by performing a double-blind, randomized, placebo-control trial. The trial evaluated patients presenting with out of hospital cardiac arrest secondary to VF or pulseless VT that is refractory to one or more shock.</li> <li> The trial randomized 3,026 patients to receive amiodarone (974), lidocaine (993), or normal saline (i.e., placebo) (1,059); the primary outcome was survival to hospital discharge and the secondary outcome was favorable neurological outcome at hospital discharge. Several sub-group analyses were planned a priori.</li> <li> No statistically significant difference was found in hospital survival or neurologic outcomes between any of the groups. Patients who had a witnessed arrest and bystander CPR had higher rates of survival with either lidocaine or amiodarone compared to saline while there was no difference between the two.</li> </ul> <p> </p> <fieldset><legend>References</legend>
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