TDNet Discover

Background: Current guidelines for treatment of cardiac arrest with a shockable rhythm recommend the administration of either amiodarone or lidocaine. There are differing opinions on the effectiveness of antiarrhythmic medications, especially given the potential adverse events and side effects that can occur with their use. Researchers undertook an evidence-based medicine systematic review to further evaluate the efficacy of amiodarone versus lidocaine versus placebo. Purpose: The purpose of this research is to examine the current literature and determine if the current protocol of antiarrhythmic medication administration improves achievement of return of spontaneous circulation (ROSC) and survival to hospital admission after cardiac arrest with ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) when compared to a placebo in an adult patient. Methods: Researchers utilized four databases: PubMed, ProQuest, UpToDate, and Cochrane and selected three high-quality meta-analyses and/or systematic reviews that compared amiodarone versus lidocaine versus placebo in adult human cardiac arrest patients within the last ten years. A quality assessment tool and a data extraction tool were applied to each of the three selected studies. Results: All three meta-analyses/systematic review articles that were selected agreed that amiodarone significantly improved survival to hospital admission. Two articles found that lidocaine was also more beneficial in survival to hospital admission than placebo, but the last article did not find a significant difference between lidocaine versus placebo. Conclusions: While lidocaine and amiodarone appear to play a role in helping patients to achieve ROSC and survival to admission after they have presented in VF/pVT, more high quality research is needed to definitively state their role in cardiac arrest