Drug therapy in advanced cardiac life support

Drug therapy during advanced cardiac life support for cardiac resuscitation continues to evolve, with new experimental and clinical data appearing each year. During the last year, important work has come forth in the following areas: optimal vaso-constrictive agents for improving coronary perfusion pressure during cardiopulmonary resuscitation; antiarrhythmic drug use for refractory ventricular fibrillation during ongoing cardiopulmonary resuscitation; and treatment of postresuscitation myocardial dysfunction. Much of the previous practice of drug therapy during cardiopulmonary resuscitation was based on anecdotal or consensus opinion. Careful prospective evaluation of drug therapy in both experimental and clinical settings is sorely needed. Such data have appeared recently for the use of vasopressin, amiodarone, and dobutamine during and after resuscitation.