title: Plasma lidocaine levels occurring with endotracheal administration during hemorrhagic shock.
abstract: During the many emergency situations in which venous access is difficult or impossible, endotracheal drug administration is an effective alternative means of delivering life-saving medications. Shock is a commonly encountered emergency situation in which endotracheal drug therapy can and is often used. Yet whether a drug given endotracheally during shock can be absorbed from the lungs and pass into the bloodstream is not known. Forty-five sets of plasma lidocaine levels drawn at 5, 15, 30 and 60 min after the administration of endotracheal lidocaine at a dose of 2 or 4 mg/kg were obtained in dogs either in shock or in a normal control group: Group I = "Non-shock" or normal control, N = 27; Group II = "Shock", N = 18. Significantly higher plasma lidocaine levels occurred in the shock group in all time periods and with either dose of lidocaine (P less than 0.001). Mean plasma lidocaine levels (micrograms/ml) at 5 min were: (at 2 mg/kg dose) Group I = 1.1, Group II = 2.0; and (at 4 mg/kg dose) Group I = 2.3, and Group II = 5.1. The dose of lidocaine, the technique of administration, and the time at which the plasma lidocaine level was drawn as well as whether shock vs. non-shock was present were all highly significant factors (P less than 0.001) in determining plasma lidocaine levels. In summary: (1) endotracheal lidocaine is absorbed during shock and (2) higher plasma lidocaine levels occur during shock than during the non-shock control state. This suggests that the dosage of endotracheal medication may need to be adjusted for various clinical conditions such as shock.
authors.affiliation: Department of Emergency Medicine, Mt. Sinai Medical Center, Cleveland, OH 44106.
authors.forename: S E
authors.initials: SE
authors.lastname: Mace
mesh_terms: D000818:Animals; D004285:Dogs; D007442:Intubation, Intratracheal; D008012:Lidocaine / Q000008:administration & dosage / Q000097:blood*; D008168:Lung / Q000473:pathology; D012771:Shock, Hemorrhagic / Q000097:blood*; D014132:Trachea
chemical_list: D008012:Lidocaine