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Vasopressin + epinephrine + methylprednisolone (VSE) is a combination therapy investigated by the National Taiwan University Hospital for the treatment of out-of-hospital cardiac arrest (OHCA). This triple-drug regimen, evaluated in the OHCA REVIVES trial, is designed to improve the rates of sustained return of spontaneous circulation (ROSC) and long-term survival compared to standard epinephrine monotherapy. The combination leverages the synergistic effects of three distinct agents: vasopressin, which acts as a potent non-adrenergic vasoconstrictor via V1 receptors; epinephrine, which provides alpha- and beta-adrenergic stimulation to increase coronary and cerebral perfusion pressure; and methylprednisolone, a corticosteroid intended to suppress the post-cardiac arrest systemic inflammatory response and improve hemodynamics. The therapy is typically administered by advanced paramedics in the prehospital setting during resuscitation efforts.
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