Abstract 1773: Increasing Amiodarone Use in Cardiopulmonary Resuscitation: An Analysis of the National Registry for Cardiopulmonary Resuscitation
Introduction - Amiodarone has supplanted lidocaine as the first-line anti-arrhythmic agent in cardiopulmonary resuscitations. We hypothesized that the use of amiodarone has increased in ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) resuscitations since its inclusion in the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care and landmark publications. We further hypothesized that increased use of amiodarone was greater in adults than in children.
Methods - The National Registry of Cardipulmonary Resuscitation, an ongoing international, retrospective registry of in-hospital resuscitation events was used to assess the pattern of amiodarone use in VF/pVT events from January 1, 2000 to July 31, 2005. Statistics by Chi-square analysis, using SAS statistical analysis software.
Results - During the study period, 14,854/29,552 (50%) of adults with VF/pVT received an antiarrhythmic drug; 8883 (60%) of those patients received amiodarone. Amiodarone use increased in adults from 25% of VF/pVT episodes in 2000 to 72% in 2005 (p < 0.001). In children, 270/553 (49%) of VF/pVT episodes received an antiarrhythmic drug; 108 (40%) of those patients received amiodarone. Amiodarone use in children increased from 13% of VF/pVT in 2000 to 44% in 2005 (p = 0.06). Adults administered any amiodarone were more likely to receive amiodarone alone (65%) compared to amiodarone and lidocaine (35%) while children were more likely to receive amiodarone and lidocaine (67%) compared to amiodarone only (33%, p < 0.001).
Conclusion - There has been a significant increase in amiodarone use for VF/pVT events over the past five years, more notably in adults than in children. These results strongly suggest that emerging data and national guidelines affect resuscitation practice patterns.