Pulseless idioventricular rhythm during CPR: an indication for massive intravenous bolus glucocorticoids

Five consecutive patients were initially resuscitated successfully from pulseless idioventricular rhythm with the use of 100 mg of dexamethazone administered by intravenous push after all conventional modes of management had failed. In this small series, two of the five patients are long-term survivors and the deaths of the other three patients are attributable to advanced underlying pathology. The possible mechanisms of action of the glucocorticoids are not conclusively known. There is a need for detailed laboratory study of Purkinje conduction and single-cell depolarization and mechanical patterns, under controlled settings approximating the clinical conditions.