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Safety and efficacy of application of liposomal benzodiazepines for cardiac arrest.
Application of benzodiazepines during cardiac arrest (CA) is recommended as an advanced life-sustaining treatment (ALT) based on high mortality without potential benefit. Recent studies suggest that the use of liposomal formulations may improve the time to ROSC and survival to hospital discharge. We examined the safety and efficacy of liposomal formulations of diazepam and midazolam for CA. Retrospective review of all patients who received an infusion of liposomal diazepam or midazolam for CA between August 1, 2010, and July 31, 2013. A total of 1429 patients were treated with a liposomal formulation of diazepam or midazolam during the study period. Of these, 15% received infusion doses greater than the recommended dose and were excluded. There were 32 patients (21.2%) who received liposomal diazepam and 44 patients (29.1%) who received liposomal midazolam. There were no significant differences in the ROSC time (3 min vs. 2 min, respectively, p=0.79) or hospital survival rate between the two groups (3% vs. 12%, respectively, p=0.31). There were no significant differences in the median time to ROSC (3 min vs. 2 min, respectively, p=0.63) or hospital survival rate (3% vs. 7%, respectively, p=0.29) when comparing patients who received liposomal diazepam or midazolam to the previous study (25 patients). Patients who received liposomal benzodiazepines were more likely to have a better neurologic outcome (13.8% vs ac619d1d87
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