Karlis George, Afantenou Sevasti
a Department of Intensive Care Medicine , Evangelismos Hospital , Greece.
b Hellenic Society of Cardiopulmonary Resuscitation.
Acta Cardiol. 2018 Aug;73(4):325-327. doi: 10.1080/00015385.2017.1389803. Epub 2017 Oct 12.
Since the publication of 2000 guidelines for resuscitation, amiodarone is considered the antiarrhythmic drug of choice for refractory ventricular fibrillation/pulseless ventricular tachycardia. However, to date there is no proven benefit in terms of neurologically intact survival to hospital discharge. A comprehensive search of the recent literature on amiodarone, nifekalant and lidocaine in cardiac arrest was performed. Amiodarone and nifekalant are superior to lidocaine with regards to the return of spontaneous circulation and survival to hospital admission. Nifekalant shows a trend towards quicker termination of ventricular fibrillation compared to amiodarone. There is great uncertainty about the efficacy of antiarrhythmics in cardiac arrest. Failure to show improvements regarding meaningful survival questions their current use and suggests the need for re-evaluating their place in cardiopulmonary resuscitation.
自2000年复苏指南发布以来，胺碘酮被视为难治性心室颤动/无脉性室性心动过速的首选抗心律失常药物。然而，迄今为止，在神经功能完好存活至出院方面尚无确凿的益处。对近期有关心脏骤停时胺碘酮、尼非卡兰和利多卡因的文献进行了全面检索。在自主循环恢复和存活至入院方面，胺碘酮和尼非卡兰优于利多卡因。与胺碘酮相比，尼非卡兰显示出更快终止心室颤动的趋势。抗心律失常药物在心脏骤停中的疗效存在很大不确定性。未能在有意义的存活方面显示出改善，这对它们目前的使用提出了质疑，并表明需要重新评估它们在心肺复苏中的地位。
