Calcium Antagonism in Cardiopulmonary Resuscitation

Drugs for CPR need reinvestigation; at the present time their use is as much an art as a science (14). American Heart Associations standards and guidelines and other recommendations for CPR call for the administration of 500 mg CaC12 i.v. routinely, in attempts to resuscitate patients with asystole or electromechanical dissociation (1). However, calcium's popularity for use in restarting the arrested heart has fallen (3,6,14). There is a lack of evidence in the literature for calcium's supposed beneficial role in cardiac resuscitation. Calcium in combination with epinephrine — the traditional drug of choice in CPR — was not experimentally investigated before. On the other hand, the effects of calcium antagonists were never examined in CPR, but several theoretical considerations seemed to favor their use. However, a proposed use of calcium antagonists during CPR would lead to the withdrawal of current recommendations for the use of calcium.