Comparison of different doses of epinephrine on myocardial perfusion and resuscitation success during cardiopulmonary resuscitation in a pig model.
Published results of dose-response effects of adrenergic drugs (epinephrine [E]) vary so much between studies because of differences in animal models and duration of ischemia before drug administration. In this investigation the effects of different doses of E on coronary perfusion pressure (CPP), left ventricular myocardial blood flow (MBF) and resuscitation success were compared during closed-chest cardiopulmonary resuscitation (CPR) after a 4-minute period of ventricular fibrillation in 28 pigs. MBF was measured during normal sinus rhythm using tracer microspheres. After 4 minutes of ventricular fibrillation CPR was performed with the use of a pneumatic piston compressor. After 4 minutes of mechanical measures only, the animals were randomly allocated into four groups of seven, receiving 0.015, 0.030, 0.045, and 0.090 mg/kg E intravenously respectively. MBF measurements were started 45 seconds after E administration; hemodynamic measurements after 90 seconds. Four minutes after the first administration, the same E dose was given before defibrillation. The CPP of animals given 0.015, 0.030, 0.045 and 0.090 mg/kg E were as follows: 16.3 +/- 6.1, 25.6 +/- 5.8, 33.2 +/- 8.4 and 30.4 +/- 6.3 mm Hg. The left ventricular MBF values were: 14 +/- 9, 27 +/- 11, 43 +/- 6, 46 +/- 10 mL/min/100 g. The differences between the groups receiving 0.015 and 0.045 mg/kg and between the groups receiving 0.015 mg/kg and 0.090 mg/kg were statistically significant (P less than .05). Resuscitation success was 14.3%, 42.9%, 100% and 86.7% respectively. A significant difference in resuscitation success was found only between 0.015 mg/kg and 0.045 mg/kg E.(ABSTRACT TRUNCATED AT 250 WORDS)
Lindner
K H
KH
Universitätsklinik für Anästhesiologie, Klinikum der Universität Ulm, Germany.
Ahnefeld
F W
FW
Bowdler
I M
IM
D000818:Animals; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004554:Electric Countershock; D004837:Epinephrine / Q000008:administration & dosage* / Q000494:pharmacology; D006323:Heart Arrest / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008863:Microspheres; D010100:Oxygen / Q000097:blood; D011868:Radioisotopes; D012079:Renal Circulation / Q000187:drug effects; D012151:Resuscitation; D013552:Swine; D014693:Ventricular Fibrillation / Q000503:physiopathology / Q000628:therapy
D007773:Lactates; D011868:Radioisotopes; D002245:Carbon Dioxide; D019344:Lactic Acid; D010100:Oxygen; D004837:Epinephrine