Olson D W, Thakur R, Stueven H A, Thompson B, Gruchow H, Hendley G E, Hargarten K M, Aprahamian C
Section of Trauma and Emergency Medicine, Medical College of Wisconsin, Milwaukee.
Ann Emerg Med. 1989 Mar;18(3):250-3. doi: 10.1016/s0196-0644(89)80408-1.
Experimental data suggest that a pure alpha-agonist, such as methoxamine, may improve the outcome of patients in ventricular fibrillation. A double-blind, randomized, prospective study was conducted in a paramedic system comparing the use of methoxamine with epinephrine in enhancing conversion of ventricular fibrillation while otherwise following American Heart Association protocols. One hundred two patients in ventricular fibrillation not responding to initial defibrillations with a pulsatile rhythm were randomized into one of two groups, each containing 51 patients. Equipressor doses of epinephrine (0.5 mg) and methoxamine (5 mg) were given intravenously and repeated according to American Heart Association guidelines. The mean age, sex ratio, and mean paramedic response times were comparable for the two groups. The mean time at scene until conversion was 22 +/- 10 minutes for methoxamine and 17 +/- 7 minutes for epinephrine (P = NS). The methoxamine group received 3.1 +/- 1.4 doses as compared with 2.8 +/- 1.3 doses for the epinephrine group (P = NS). Conversion rate, defined as the percentage of patients who developed a pulse during resuscitation, was 27.5% for the methoxamine group and 49.0% for the epinephrine group (P less than or equal to .03). Successful resuscitation, defined as the conveyance of a patient to an emergency department with a pulse and rhythm, was 17.7% for the methoxamine group and 39.2% for the epinephrine group (P less than or equal to .02). Save rate, defined as the percentage of patients discharged alive after hospitalization, was 7.8% for the methoxamine group and 19.6% for the epinephrine group (P less than or equal to .07).(ABSTRACT TRUNCATED AT 250 WORDS)
实验数据表明，一种纯α受体激动剂，如甲氧明，可能会改善室颤患者的预后。在一个护理急救系统中进行了一项双盲、随机、前瞻性研究，比较了甲氧明与肾上腺素在促进室颤转复方面的作用，同时遵循美国心脏协会的方案。102例对初始除颤无反应且无脉搏节律的室颤患者被随机分为两组，每组51例。按照美国心脏协会指南静脉给予等量的肾上腺素（0.5毫克）和甲氧明（5毫克），并重复给药。两组的平均年龄、性别比例和护理急救平均反应时间具有可比性。甲氧明组从到达现场到转复的平均时间为22±10分钟，肾上腺素组为17±7分钟（P=无统计学意义）。甲氧明组接受3.1±1.4次给药，而肾上腺素组为2.8±1.3次给药（P=无统计学意义）。转复率定义为复苏期间出现脉搏的患者百分比，甲氧明组为27.5%，肾上腺素组为49.0%（P≤0.03）。成功复苏定义为将有脉搏和节律的患者转运至急诊科，甲氧明组为17.7%，肾上腺素组为39.2%（P≤0.02）。挽救率定义为住院后存活出院的患者百分比，甲氧明组为7.8%，肾上腺素组为19.6%（P≤0.07）。（摘要截短于250字）
