Role of Vasopressors in Cardiac Arrest

Evidence provides weak support for the routine use of vasopressors in cardiac arrest where the quality of CPR and post arrest care are unknown and the drug is given late. In these pragmatic settings, epinephrine improves clinical outcomes, but does so at the price of increasing the proportion of patients surviving with poor neurologic function at 30 days. In settings where the quality of CPR and post arrest care are optimized the additive effect of epinephrine on clinical outcomes is not significantly different. Well designed efficacy trials are needed where routine cardiac arrest care is optimized.