Hydrocortisone and arginine vasopressin in post-resuscitation shock: the HYVAPRESS trial
Résumé
Despite advancements in prehospital management and standardization of advanced life support through wide diffusion of international guidelines, the overall prognosis of patients who suffered cardiac arrest (CA) remains poor. About 20 up to 30% of patients admitted to the hospital after a successful resuscitation of out-of-hospital CA are discharged alive and free from significant neurological impairment 1,2 .For in-hospital CA, the survival rate reaches approximately 25%, although patients who experience CA in non-monitored units such as medical and surgical wards have the worst outcomes, with survival rates below 5%. 3 This high early mortality rate is attributed to the concept of post-resuscitation syndrome, typically divided into two consecutive phases: an initial reperfusion injury leading to multiple organ failure and subsequent poor neurological outcomes resulting from anoxic brain injury. 4
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