In modern ACLS guidelines, which statement about vasopressor use is accurate?

In modern ACLS guidelines, which statement about vasopressor use is accurate?

• A. Vasopressin is not routinely recommended; epinephrine remains vasopressor of choice
• B. Epinephrine has been removed from standard guidelines
• C. Norepinephrine is now the first-line vasopressor in all arrests
• D. Dopamine is preferred for unstable arrests

Answer: (A)

During CPR the goal of vasopressors is to boost coronary and cerebral perfusion by raising diastolic aortic pressure. Epinephrine achieves this effectively through alpha-adrenergic vasoconstriction and improves the chances of return of spontaneous circulation. The modern ACLS guidance continues to designate epinephrine as the vasopressor of choice for cardiac arrest. Vasopressin was studied as an alternative, but evidence has not shown a clear outcome benefit when used routinely, so it is not recommended as a standard addition to the epinephrine protocol. That is why the statement that vasopressin is not routinely recommended while epinephrine remains the vasopressor of choice is the best answer. The other options don’t fit because norepinephrine has not replaced epinephrine as first-line in all arrests, and dopamine is not the preferred agent for unstable arrests.

During CPR the goal of vasopressors is to boost coronary and cerebral perfusion by raising diastolic aortic pressure. Epinephrine achieves this effectively through alpha-adrenergic vasoconstriction and improves the chances of return of spontaneous circulation. The modern ACLS guidance continues to designate epinephrine as the vasopressor of choice for cardiac arrest. Vasopressin was studied as an alternative, but evidence has not shown a clear outcome benefit when used routinely, so it is not recommended as a standard addition to the epinephrine protocol. That is why the statement that vasopressin is not routinely recommended while epinephrine remains the vasopressor of choice is the best answer. The other options don’t fit because norepinephrine has not replaced epinephrine as first-line in all arrests, and dopamine is not the preferred agent for unstable arrests.