Use of beta-blockers for the treatment of cardiac arrest due to ventricular fibrillation/pulseless ventricular tachycardia: A systematic review

Use of beta-blockers for the treatment of cardiac arrest due to ventricular fibrillation/pulseless ventricular tachycardia: A systematic review

Author Oliveira, Felipe Carvalho de Google Scholar
Feitosa-Filho, Gilson Soares Google Scholar
Fonteles Ritt, Luiz Eduardo Autor UNIFESP Google Scholar
Institution Escola Bahiana Med & Saude Publ
Hosp Santa Izabel
Universidade Federal de São Paulo (UNIFESP)
Abstract Introduction: Advanced Life Support guidelines recommend the use of epinephrine during Cardiopulmonary Resuscitation (CPR), as to increase coronary blood flow and perfusion pressure through its alpha-adrenergic peripheral vasoconstriction, allowing minimal rises in coronary perfusion pressure to make defibrillation possible. Contrasting to these alpha-adrenergic effects, epinephrine's beta-stimulation may have deleterious effects through an increase in myocardial oxygen consumption and a reduction of subendocardial perfusion, leading to postresuscitation cardiac dysfunction.Objective: the present paper consists of a systematic review of the literature regarding the use of beta-blockade in cardiac arrest due to ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT).Methods: Studies were identified through MEDLINE electronic databases research and were included those regarding the use of beta-blockade during CPR.Results: Beta-blockade has been extensively studied in animal models of CPR. These studies not only suggest that beta-blockade could reduce myocardial oxygen requirements and the number of shocks necessary for defibrillation, but also improve postresuscitation myocardial function, diminish arrhythmia recurrences and prolong survival. A few case reports described successful beta-blockade use in patients, along with two prospective human studies, suggesting that it could be safe and effectively used during cardiac arrest in humans.Conclusion: Even though the existing literature points toward a beneficial effect of beta-blockade in patients presenting with cardiac arrest due to VF/pulseless VT, high quality human trials are still lacking to answer this question definitely. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
Keywords Cardiopulmonary Resuscitation
Ventricular fibrillation
Beta-blockade
Beta-blockers
Advanced Life Support
Language English
Date 2012-06-01
Published in Resuscitation. Clare: Elsevier B.V., v. 83, n. 6, p. 674-683, 2012.
ISSN 0300-9572 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 674-683
Origin http://dx.doi.org/10.1016/j.resuscitation.2012.01.025
Access rights Closed access
Type Review
Web of Science ID WOS:000304669700016
URI http://repositorio.unifesp.br/handle/11600/34962

Show full item record




File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account