vasopressin + epinephrine + methylprednisolone + hydrocortisone

This is a **combination therapy** comprising vasopressin, epinephrine (adrenaline), methylprednisolone, and hydrocortisone. It is primarily investigated and trialed for use during cardiopulmonary resuscitation (CPR) in patients with **in-hospital cardiac arrest** requiring vasopressors. - **Mechanism of action:** - Vasopressin acts as a potent vasoconstrictor by stimulating V1 receptors on vascular smooth muscle, increasing coronary and cerebral perfusion pressure during CPR. - Epinephrine acts on alpha- and beta-adrenergic receptors, causing vasoconstriction (alpha1), increasing heart rate and contractility (beta1), and bronchodilation (beta2), further enhancing perfusion pressure. - Methylprednisolone and hydrocortisone are glucocorticoid corticosteroids. Methylprednisolone is given as a single dose during CPR to reduce systemic inflammation and support cardiovascular function. Hydrocortisone is administered postresuscitation as a stress-dose infusion to treat or prevent post-arrest shock, support blood pressure, and modulate the stress response. - **Clinical evidence:** Randomized controlled trials indicate that this combination (sometimes called “VSE” for vasopressin, steroids, and epinephrine) improves return of spontaneous circulation (ROSC), survival to hospital discharge, and neurologically favorable outcomes compared with standard epinephrine-based CPR regimens. - **Primary indication:** Cardiac arrest requiring vasopressors, specifically **in-hospital cardiac arrest** with post-resuscitation shock[1][3][7].

Other names

vasopressin-steroids-epinephrine combinationVSE combination