Despite the use of conventional treatment modalities, the probability of survival for patients experiencing cardiac arrest due to ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) remains quite poor. Therefore, the management of cardiac arrest remains a challenge. The most recent Advanced Cardiovascular Life Support (ACLS) guidelines have adopted an evidence-based approach toward the treatment of pulseless VT/VF. A number of evidence-based changes have been made in the treatment algorithms for these life-threatening arrhythmias, including the new recommendations for using vasopressin and intravenous amiodarone. This article will provide an overview of the evidence-based approach that was used in the development of the 2000 ACLS guidelines and will summarize the key trials that were used to support the inclusion of vasopressin and intravenous amiodarone in the pulseless VT/VF treatment algorithm. Additionally, dosing and administration issues for these agents will be discussed.
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