Epinephrine, vasopressin and steroids for in-hospital cardiac arrest: the right cocktail therapy?

Methods Objective: To determine whether combined vasopressinepinephrine during cardiopulmonary resuscitation (CPR) and corticosteroid supplementation during and after CPR improve survival to hospital discharge with a Cerebral Performance Category (CPC) score of 1 or 2 in vasopressor-requiring, in-hospital cardiac arrest. Design: Randomized, double-blind, placebo-controlled, parallel-group trial performed from 1 September 2008 to 1 October 2010. Setting: Three Greek tertiary care centers. Subjects: Consecutive in-hospital cardiac arrest patients requiring epinephrine and aged more than 18 years (n = 268). Intervention: Patients received either vasopressin (20 IU/ CPR cycle) plus epinephrine (1 mg/CPR cycle; cycle duration approximately 3 minutes; VSE group, n = 130) or saline placebo plus epinephrine (1 mg/CPR cycle;