Effect of angiotensin II on myocardial blood flow and acid-base status in a pig model of cardiopulmonary resuscitation.
The effect of angiotensin II on myocardial blood flow and acid-base status during cardiopulmonary resuscitation (CPR) was assessed. Fourteen pigs were allocated randomly to receive either 0.9% saline (n = 7) or 0.05 mg/kg angiotensin II (n = 7) after 4 min of ventricular fibrillation and 3 min of open-chest CPR. Total myocardial blood flow (measured with radiolabeled microspheres) before, 90 s, and 5 min following drug administration was 74 +/- 18, 62 +/- 12, and 54 +/- 11 mL.min-1 x 100g-1 (mean +/- SD) in the control, and 72 +/- 17, 125 +/- 25, and 74 +/- 20 mL.min-1 x 100 g-1 in the angiotensin II group (P < 0.001 at 90 s and P < 0.05 at 5 min). The PCO2 of coronary venous blood at 90 s after drug administration was 82 +/- 8 mm Hg in the control group as compared to 47 +/- 9 mm Hg in the angiotensin II group (P < 0.001). Only three of the seven control group animals could be resuscitated successfully, whereas all of the angiotensin II-treated pigs survived the 1-h observation period (P < 0.05), during which neither arterial hypertension nor bradycardia was observed. Angiotensin II was associated with an improvement of myocardial blood flow during CPR and short-term resuscitation success. The increase in myocardial perfusion is associated with a lower coronary venous PCO2 and a higher coronary venous pH. The authors conclude that angiotensin II administration facilitated cardiopulmonary resuscitation.
Lindner
K H
KH
Universitätsklinik für Anästhesiologie, Klinikum der Universität Ulm, Donau, Germany.
Prengel
A W
AW
Pfenninger
E G
EG
Lindner
I M
IM
D000136:Acid-Base Equilibrium / Q000187:drug effects* / Q000502:physiology; D000804:Angiotensin II / Q000627:therapeutic use*; D000818:Animals; D016887:Cardiopulmonary Resuscitation; D003326:Coronary Circulation / Q000187:drug effects* / Q000502:physiology; D006323:Heart Arrest / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D013552:Swine
D000804:Angiotensin II