Adenosine during cardiac arrest and cardiopulmonary resuscitation: a placebo-controlled, randomized trial.
BACKGROUND AND HYPOTHESIS TESTED: The effects of adenosine (100 micrograms/kg/min; n = 7) were examined during rodent cardiopulmonary resuscitation (CPR). Change in coronary artery perfusion pressure, end-tidal PCO2, and arterial acid-base status of anesthetized, male, Sprague-Dawley rats were compared with CPR controls (0.9% sodium chloride; n = 7) and with sham controls (n = 9). Sustained ventricular fibrillation was induced and precordial chest compression was followed by defibrillation.


RESULTS
After 6 mins of cardiac arrest, six (86%) of seven adenosine-treated animals were resuscitated after adenosine infusion and four (57%) of seven control animals were resuscitated after sodium chloride infusion. During chest compression, coronary artery perfusion pressure was 7 +/- 2 mm Hg after adenosine, but was 22 +/- 3 mm Hg in the controls (p less than .01). Parallel decreases were observed in mean aortic pressure. Arterial and end-tidal PCO2 significantly (p less than .01) decreased after adenosine. These changes contrasted with a second control group of nine identically prepared animals which, in the absence of ventricular fibrillation and subsequent chest compression, demonstrated no changes in hemodynamic, respiratory, or blood gas variables.


CONCLUSIONS
Adenosine decreased coronary artery perfusion pressure. However, despite marked reductions in coronary artery perfusion pressure, survival was not compromised after adenosine infusion in this rodent model of CPR.
von Planta
M
M
Department of Internal Medicine, University Hospital, Basel, Switzerland.
von Planta
I
I
Wagner
O
O
Scheidegger
D
D
D000136:Acid-Base Equilibrium / Q000187:drug effects; D000241:Adenosine / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D000818:Animals; D001784:Blood Gas Analysis; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D003326:Coronary Circulation / Q000187:drug effects; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D007262:Infusions, Intravenous; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains; D015996:Survival Rate; D013990:Tidal Volume / Q000187:drug effects
D000241:Adenosine