The first case series analysis on efficacy of esmolol injection for in-hospital cardiac arrest patients with refractory shockable rhythms in China

• DOI: 10.3389/fphar.2022.930245
• Publication Date: 2022-09-30T05:20:20Z
• Authors: Rui Lian; Guochao Zhang; Shengtao Yan; Lichao Sun; Wen Gao; Jianping Yang; Guonan Li; Rihong Huang; Xiaojie Wang; Renyang Liu; Guangqing Cao; Yong Wang; Guoqiang Zhang
• Keywords: Esmolol; Bolus (digestion); Refractory (planetary science)

Background: This study assessed the effects of esmolol injection in patients with in-hospital cardiac arrest (IHCA) refractory ventricular fibrillation (VF)/pulseless tachycardia (pVT). Methods: From January 2018 to December 2021, 29 IHCA shockable rhythm were retrospectively reviewed. Esmolol was administered after advanced cardiovascular life support (ACLS)-directed procedures, and outcomes assessed. Results: Among cases, rates sustained return spontaneous circulation (ROSC), 24-h ROSC, 72-h ROSC 79%, 62%, 59%, respectively. Of those patients, 59% ultimately survived discharge. Four insufficiency died. The duration from CA infusion significantly shorter for survival group (SG) than dead (DG) (12 min, IQR: 8.5-19.5 vs. 23.5 14.4-27 min; p = 0.013). 76% (22 29) started administration second dose amiodarone. No significant difference observed rate between this groups an bolus simultaneously or before amiodarone (43% 64%, 0.403). 31% (9 defibrillation attempts ≤ 5, while remaining 69% received fifth attempt. differences ≥ (67% 60%, 0.73), 55%, 0.56), hospital discharge 0.56) 5 > 5. Conclusion: rhythms receiving exhibited a high chance Patients end-stage heart failure tended have attenuated benefits beta-blockers. Further large-scale, prospective studies are necessary determine rhythms.