VF/pVT cardiac arrest 동안 항부정맥 약물: Amiodarone 또는 lidocaine

2015년 cardiac arrest algorithm에서 defirbillation을 시행할 수 있으면 shock을 주고

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CPR을 시행 한 후 또 defirbillation을 시행할 수 있으면 shock을 주고 CPR을 시행하면서 3-5분마다 에피네프린을 주사하며

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또 defirbillation을 시행할 수 있으면 shock을 주고 항부정맥 약물로 아미오다론을 투약하는 것으로 되어 있습니다.

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즉, 제세동과 에피네프린 투약에도 지속되는 VF/pVT에서 아미오다론을 사용하는 것으로 되어 있습니다.

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그러나 2018년 알고리즘에서는 아미오다론 또는 리도케인 모두 가능한 것으로 변경되었습니다.

Amiodarone or lidocaine may be considered for VF/pVT that is unresponsive to defibrillation. These drugs may be particularly useful for patients with witnessed arrest, for whom time to drug administration may be shorter. (Class IIb; LOE B-R) (2018 ACLS)

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The routine use of magnesium for cardiac arrest is not recommended in adult patients (Class III: No Benefit; LOE C-LD). Magnesium may be considered for torsades de pointes (ie, polymorphic VT associated with long-QT interval). (Class IIb; LOE C-LD) (2018 ACLS)

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Adult cardiac arrest algorithm 2018 update

CPR: cardiopulmonary resuscitation; VF: ventricular fibrillation; pVT: pulseless ventricular tachycardia; PEA: pulseless electrical activity; IV: intravenous; IO: intraosseous; PETCO2: end-tidal partial pressure of carbon dioxide; ET: endotracheal.

Reference:

Web-based Integrated 2010 & 2015 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care – Part 8: Post-Cardiac Arrest Care. Available at: https://eccguidelines.heart.org/circulation/cpr-ecc-guidelines/part-8-post-cardiac-arrest-care/ (Accessed on October 10, 2019).

Reprinted with permission. Web-based Integrated 2010, 2015, & 2017 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care – Part 7: Adult Advanced Cardiovascular Life Support. Copyright © 2018 American Heart Association, Inc.

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REF. UpToDate 2019.12.05