{"id":598,"date":"2013-07-01T10:00:00","date_gmt":"2013-07-01T10:00:00","guid":{"rendered":"http:\/\/www.emlitofnote.com\/?p=598"},"modified":"2016-08-01T08:58:01","modified_gmt":"2016-08-01T15:58:01","slug":"the-return-of-lidocaine","status":"publish","type":"post","link":"https:\/\/www.emlitofnote.com\/?p=598","title":{"rendered":"The Return of Lidocaine?"},"content":{"rendered":"<p>Lidocaine as adjunctive treatment following cardiac arrest in the context of ventricular fibrillation\/ventricular tachycardia has generally fallen out of favor and been replaced with amiodarone, a result of <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/3047448\">historical data<\/a> and more <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11907287\">recent trials<\/a>. &nbsp;However, the quality of the evidence is generally poor, and confounders are frequent.<\/p>\n<p>So, here&#8217;s some more chaotic, retrospective evidence gathered over the course of 16 years. &nbsp;This is the King County registry of OHCA, of which 1,721 patients with VF\/VT and ROSC were identified. &nbsp;Of these, 1296 patients received prophylactic lidocaine after ROSC, in theory, to prevent re-occurrence of VF\/VT. &nbsp;And, in both their unadjusted, adjusted, and propensity matched cohorts, there was a reduction in recurrence of VT\/VF. &nbsp;However, in their propensity-matched cohort \u2013 which may or may not be a better tool for comparing two groups than their multivariate adjustment \u2013 there was no difference in admission rate or survivors to hospital discharge.<\/p>\n<p>At the least, as these authors suggest, this data provides the clinical equipoise needed to justify prospective OHCA trials exempt from informed consent.<\/p>\n<p>&#8220;Prophylactic lidocaine for post resuscitation care of patients with&nbsp;out-of-hospital ventricular fibrillation cardiac arrest&#8221;<br \/><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23743237%E2%80%8E\">www.ncbi.nlm.nih.gov\/pubmed\/23743237\u200e<\/a><\/p>\n\n<div class=\"twitter-share\"><a href=\"https:\/\/twitter.com\/intent\/tweet?via=emlitofnote\" class=\"twitter-share-button\">Tweet<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Lidocaine as adjunctive treatment following cardiac arrest in the context of ventricular fibrillation\/ventricular tachycardia has generally fallen out of favor and been replaced with amiodarone, a result of historical data and more recent trials. &nbsp;However, the quality of the evidence is generally poor, and confounders are frequent. So, here&#8217;s some more chaotic, retrospective evidence gathered &hellip; <a href=\"https:\/\/www.emlitofnote.com\/?p=598\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;The Return of Lidocaine?&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[31,30],"tags":[],"class_list":["post-598","post","type-post","status-publish","format-standard","hentry","category-cardiac-arrest","category-resuscitation"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7KesJ-9E","jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/598","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=598"}],"version-history":[{"count":1,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/598\/revisions"}],"predecessor-version":[{"id":2641,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/598\/revisions\/2641"}],"wp:attachment":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=598"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=598"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=598"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}