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Báo cáo y học: " Recently published papers: Topical issues in pharmacology"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Recently published papers: Topical issues in pharmacology. | Critical Care June 2002 Vol 6 No 3 Williams and Ball Commentary Recently published papers Topical issues in pharmacology Gareth Williams1 and Jonathan Ball2 Clinical Fellow in Intensive Care Medicine St. George s Hospital Blackshaw Road Tooting London UK 2Lecturer in Intensive Care Medicine St. George s Hospital Blackshaw Road Tooting London UK Correspondence Gareth Williams gareth@williams9586.freeserve.co.uk Published online 9 May 2002 Critical Care 2002 6 196-197 2002 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X The use of pharmacological agents in intensive care units ICUs is ever on the increase with novel therapies appearing in the literature regularly. The complexities of polypharmacy are a challenge to the intensivist and any guidance as to which drugs to use when to use them and how much to use is always welcome. Happily therefore over the past 2 months a number of interesting papers and articles have appeared covering drugs both new and old. Cardiac arrest in the community is associated with a very high mortality rate. Ventricular fibrillation VF is both the most common mode of arrest and carries the best prognosis if early defibrillation is available 1 . However a subgroup of patients with VF are resistant to direct current defibrillation in which case an antiarrythmic agent is required but very few randomized controlled trials RCTs have been conducted to verify the efficacy of any particular agent. Dorian and colleagues 2 compared lidocaine with amiodarone in the management of out-of-hospital shockresistant VF. In a double-blind RCT 347 patients were randomly assigned to either lidocaine 1.5 mg kg or amiodarone 5 mg kg as an initial dose. In addition a further 1.5 and 2.5 mg kg respectively were given if required. The primary end-point was survival to hospital. A total of 41 patients 22.8 in the amiodarone group and 20 patients 12.0 in the lidocaine group survived to hospital P 0.009 odds ratio 2.17 95 confidence interval 1.21-3.83 . .