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beta-Blockers for the treatment of cardiac arrest from ventricular fibrillation?

机译：β受体阻滞剂用于治疗心室颤动引起的心脏骤停？

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More than 160,000 people suffer sudden cardiac death each year in the US. It is estimated that ventricular fibrillation (VF) is the initial rhythm in approximately 30% of these cases. Ventricular fibrillation that does not respond to the first few defibrillation attempts is associated with mortality rates of up to 97%. Currently, no pharmacological intervention has been shown to increase long-term survival in patients with shock-refractory VF. The purpose of this review article is to evaluate whether beta-blocker administration during the resuscitation of cardiac arrest from VF or pulseless ventricular tachycardia (VT) improves outcome. We searched the MEDLINE and EMBASE databases for human clinical trials, animal experimental trials, review articles, case reports and abstracts published between 1966 and September 2006. No human prospective randomized controlled trial has studied the effects of beta-blocker administration during VF directly. Prospective trials of anti-arrhythmics with beta-blocking properties have been published, as well as several case reports/case series and experimental animal studies. The evidence thus far suggests that beta-blockade during resuscitation from VF may be associated with increasing rates of resuscitation, greater post-resuscitation survival, and improved post-resuscitation myocardial function. These positive effects on outcome may be mediated by a decrease in the oxygen requirements of the fibrillating heart, thus improving the overall balance between myocardial oxygen supply and demand during resuscitation. While no significant detrimental effects directly related to low dose beta-blockade during VF have been reported in the studies reviewed, concerns relating to possible loss of myocardial contractility and hypotension remain. To this day, high quality human trials are lacking. Preliminary human studies are needed to assess the effects of beta-blockers in the treatment of cardiac arrest from ventricular fibrillation or pulseless VT further.
机译：在美国，每年有超过160,000人因心脏猝死。据估计，在大约30％的此类病例中，心室纤颤（VF）是其初始节律。对最初的几次除纤颤尝试无反应的心室纤颤的死亡率高达97％。目前，尚无药物治疗可增加休克难治性VF患者的长期生存率。这篇综述文章的目的是评估从VF或无脉性室性心动过速（VT）进行的心脏骤停复苏期间给予β-受体阻滞剂是否能改善预后。我们在MEDLINE和EMBASE数据库中搜索了1966年至2006年9月之间发表的人体临床试验，动物实验试验，评论文章，病例报告和摘要。尚无人类前瞻性随机对照试验直接研究了VF期间使用β-受体阻滞剂的效果。具有β阻滞特性的抗心律失常药物的前瞻性试验已经发表，以及一些病例报告/病例系列和实验动物研究。迄今为止的证据表明，从VF复苏期间进行β受体阻滞可能与复苏率增加，复苏后生存期延长和复苏后心肌功能改善有关。这些对结果的积极影响可能是通过降低颤动心脏的氧气需求来介导的，从而改善了复苏过程中心肌供需之间的总体平衡。虽然在回顾的研究中没有报告与VF期间低剂量β受体阻滞直接相关的显着有害作用，但仍存在与心肌收缩力和低血压可能丧失有关的担忧。直到今天，仍缺乏高质量的人体试验。需要进行初步的人体研究，以评估β受体阻滞剂在进一步治疗由心室纤颤或无脉性室速引起的心脏骤停中的作用。

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