New trends in the pharmacologic management of cardiac arrest

In recent years a number of trends in the pharmacologic management of cardiac arrest have developed. Interventions that should be considered, especially for patients with refractory ventricular fibrillation, are high-dose epinephrine and additional antifibrillatory therapies, such as amiodarone and magnesium sulfate. Other advances in the management of refractory ventricular fibrillation include an improved understanding of the mechanism of action of epinephrine and other pressor agents in the arrested heart, and refined indications and recommendations for the use of sodium bicarbonate, lidocaine, bretylium and beta-blocking agents.