New Guidelines for Cardiopulmonary Resuscitation

Michael A. Gropper, MD, PhD


April 10, 2001


What's new as far as guidelines for cardiopulmonary resuscitation?

Udomsak Boonsongsup, MD

Response from Michael A. Gropper, MD, PhD

New guidelines have been published in the last year.[1,2] The most important changes include the addition of amiodarone and vasopressin to the algorithm for ventricular fibrillation and pulseless ventricular tachycardia. The use of 40 units of vasopressin has been recommended as an alternative to epinephrine as an adjunct to restore circulation after unsuccessful cardioversion. Bretylium is no longer recommended in this algorithm because of its lack of efficacy.

Amiodarone was found to be efficacious in a recent New England Journal of Medicine study when given for out-of-hospital cardiac arrest due to shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.[3] Please note, however, that the amiodarone was administered only after administration of epinephrine, prior to attempted cardioversion.

Additional recommendations include the use of automated defibrillators. All of the changes and the new algorithms are described in the following references.