Nimodipine

Based on the observation that nimodipine reduced death or severe ischemic deficits in subarachnoid hemorrhage (23), several clinical trials were conducted (24,25). An open pilot study on the safety and efficacy of nimodipine in patients after out-of-hospital ventricular CA (24) was followed by a controlled, randomized clinical study. The clinical trial excluded prolonged resuscitation (>30 minutes), limited the cases to ventricular fibrillation and ventricular tachycardia (25), and used the Glasgow Outcome Score (GOS) at one year and a secondary endpoint of Glasgow Coma Score (GCS 1) at 24 hours and 1 week as outcomes. Interval functional evaluations were conducted at 3 and 12 months using the Mini-mental Examination, Barthels, and Katz ADL Scale (24).

Nimodipine was given as a bolus of 10 pg/kg followed by 0.5 pg/kg over 24 hours, and the treated group was compared to a placebo group (24). The study agent was given immediately after resuscitation, which was usually at the site of the resuscitation, with 75 patients in the nimodipine arm and 80 patients in the placebo arm. The 1-year good outcome (GOS 1) for the nimodipine-treated patients was 29%, compared to placebo with 24%. One-year mortalities were 60% in the nimodipine-treated group and 64% in the placebo group (23).

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