For pediatric in-hospital cardiac arrest which is better-Lidocaine or amiodarone
A study published in Journal Resuscitation has found that that there was no significant difference in clinical outcomes between those receiving lidocaine compared to amiodarone In children with cardiac arrest receiving antiarrhythmics for a shockable rhythm.;
Lidocaine and amiodarone are both included in the pediatric cardiac arrest guidelines as treatments of shock-refractory ventricular fibrillation or pulseless ventricular tachycardia, although there is limited evidence to support this recommendation.
A study was conducted to find out which of lidocaine or amiodarone is acceptable and preferred over another in PALS for shock-refractory ventricular fibrillation. This was a propensity matching study based on a pediatric in-hospital arrest registry over an 18 year period with shock-refractory v-fib or pulseless v-tach.
The researchers included pediatric patients (≤18 years) with an in-hospital cardiac arrest between 2000 and 2018, who presented with an initial or subsequent shockable rhythm (ventricular fibrillation and pulseless ventricular tachycardia) in this cohort study. A total of 365 patients were available for the analysis, of which 180 (49%) patients were matched on the propensity score. The median age in the raw cohort was 6 (quartiles, 0.5-14) years, 164 (45%) patients were female, and 238 (65%) patients received an antiarrhythmic for an initial shockable rhythm.
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