Vasopressin was not better than epinephrine for out-of-hospital cardiac arrest.

P a t i e n t s 1219 patients with an out-of-hospital cardiac arrest who presented with ventricular fibrillation, pulseless electrical activity, or asystole requiring cardiopulmonary resuscitation (CPR) with vasopressor therapy. Exclusion criteria were successful defibrillation without a vasopressor, terminal illness, no intravenous access, hemorrhagic shock, cardiac arrest after trauma, pregnancy, age < 18 years, or presence of a do-not-resuscitate order. 1186 patients (97%) completed the study (mean age 66 y, 70% men). I n t e r v e n t i o n Patients were allocated to vasopressin (Pitressin), 40 IU (n = 589), or epinephrine (Suprarenin), 1 mg (n = 597). If circulation was not restored in 3 minutes, the same drug at the same dose was injected again. If circulation was still not restored, patients received an additional injection of epinephrine at the discretion of the emergency physician managing the CPR attempt.