Post by Kris Thompson on Jan 11, 2017 9:16:50 GMT -6
Esmolol probably works for refractory v-fib and, in my opinion, is something we should add to our ACLS toolbox. Smith, et al. published this in 2014 but not many caught on. Lee, et al. published in October demonstrating very similar results. These aren't large, blinded studies; but they do point in that direction. If you've shocked the patient a few times (maybe even using two defibrillators at once), given standard ACLS pharmacological treatment, and the patient is still in VF, you should probably consider this.
Driver, B. E., Debaty, G., Plummer, D. W., & Smith, S. W. (2014). Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular fibrillation. Resuscitation, 85(10), 1337-1341. www.ncbi.nlm.nih.gov/pubmed/25033747
Lee, Y. H., Lee, K. J., Min, Y. H., Ahn, H. C., Sohn, Y. D., Lee, W. W., ... & Park, S. O. (2016). Refractory ventricular fibrillation treated with esmolol. Resuscitation, 107, 150-155.Lee, Y. H., Lee, K. J., Min, Y. H., Ahn, H. C., Sohn, Y. D., Lee, W. W., ... & Park, S. O. (2016). Refractory ventricular fibrillation treated with esmolol. Resuscitation, 107, 150-155. www.ncbi.nlm.nih.gov/pubmed/27523955
Driver, B. E., Debaty, G., Plummer, D. W., & Smith, S. W. (2014). Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular fibrillation. Resuscitation, 85(10), 1337-1341. www.ncbi.nlm.nih.gov/pubmed/25033747
Lee, Y. H., Lee, K. J., Min, Y. H., Ahn, H. C., Sohn, Y. D., Lee, W. W., ... & Park, S. O. (2016). Refractory ventricular fibrillation treated with esmolol. Resuscitation, 107, 150-155.Lee, Y. H., Lee, K. J., Min, Y. H., Ahn, H. C., Sohn, Y. D., Lee, W. W., ... & Park, S. O. (2016). Refractory ventricular fibrillation treated with esmolol. Resuscitation, 107, 150-155. www.ncbi.nlm.nih.gov/pubmed/27523955