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University of Pittsburgh Schools of the Health Sciences

Pitt Researchers To Collaborate With Paramedics To See If The Drug Vasopressin Can Improve Outcome Of Cardiac Arrest

PITTSBURGH, March 5, 2003 More than 350 cardiac arrest cases occur in the City of Pittsburgh each year, according to statistics from researchers in the department of emergency medicine at the University of Pittsburgh School of Medicine.

Can survival for patients who suffer out-of-hospital cardiac arrest be improved by using a generic drug called vasopressin?

To help answer this question, emergency medicine researchers are participating in a local, one-year research study known as the Vasopressin in Cardiac Arrest Research Project. Researchers will be collaborating with City of Pittsburgh paramedics, who will administer the drug.

Paramedics in Pennsylvania are trained how to use vasopressin for advanced cardiac life support, but most do not carry this drug as part of their treatment regimen.

During this study, each City of Pittsburgh paramedic crew will be asked to carry research vials. Half of the paramedics will receive vials containing vasopressin and half of the paramedics will receive vials containing saline (salt water). None of the paramedics will know whether the vials contain the active drug or the saline.

The paramedics will perform their current standard of care for cardiac arrest, including giving adrenaline (epinephrine), and additionally, will administer the contents of the research vial. It is expected that one-half of patients in cardiac arrest will receive vasopressin in addition to their regular treatment. The researchers hope to give vasopressin to 162 patients in cardiac arrest. A total of 324 people may participate in the study.

When paramedics are called to the scene of a patient in cardiac arrest, they typically provide advanced tools to help the patient breathe and administer drugs like epinephrine to help promote blood flow to the heart, making it more likely to resume beating. Currently, the only blood flow-promoting drug approved for use by paramedics is epinephrine.

During the vasopressin study, an emergency medicine physician from the University of Pittsburgh will ride with paramedics in the ambulance. It is not unusual for City of Pittsburgh paramedics to have emergency medicine physicians working along side them in the field and is part of the required training for emergency medicine residents at the University of Pittsburgh.

Information gathered during the study will enable researchers to examine whether there is any change in the proportion of victims whose hearts restart after receiving the vasopressin.

If results of this study show a significant increase in resuscitation from sudden cardiac arrest, vasopressin may eventually win approval for use by all paramedics, says Clifton W. Callaway, M.D., Ph.D., assistant professor of emergency medicine at the University of Pittsburgh School of Medicine and principal investigator of the vasopressin study. Additionally, it is necessary to conduct this study in the out-of-hospital setting because victims of cardiac arrest often arrive at the hospital too late for the drug to do any good.

Recent studies in Canada and Europe have shown that vasopressin was equivalent or superior to adrenaline when used as a treatment for cardiac arrest. Based on these studies, the American Heart Association recommends vasopressin as the drug to be considered for the treatment of cardiac arrest. However, it is unknown whether vasopressin is helpful when used for victims of cardiac arrest under conditions like those encountered by paramedics in the United States.

Because this study could affect anyone living in Pittsburgh, both the university and the researchers are seeking comments from the public.

To explain the research and answer questions, the Pitt researchers are holding a public forum 6:30 7:30 p.m., Thursday, March 13 in the Lower Lounge of the William Pitt Union, corner of Fifth Ave. and Bigelow Blvd. in Oakland.

According to federal law and university policy, those who participate in a clinical research study must provide informed consent. Because of the nature of this trial, it is impossible to obtain consent at the time of cardiac arrest. For this reason, the researchers are notifying the public that informed consent will be waived. Researchers will make every attempt to be in contact with family members and, if possible, the cardiac arrest patient to obtain consent at a later time.

For more information about the public forum, or to make comments or ask questions about the vasopressin study, researchers can be contacted at the following:

By Telephone: Vasopressin in Cardiac Arrest Research Project 412-647-2671.

By E-mail: callawayCW@upmc.edu

By Mail: University of Pittsburgh
Department of Emergency Medicine
230 McKee Place, Suite 400
Pittsburgh, Pa. 15213
Attention: Clifton Callaway, principal investigator

Funding for the Vasopressin in Cardiac Arrest Research Project is supported by the Pittsburgh Emergency Medicine Foundation.

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