title: Epinephrine application via an endotracheal airway and via the Combitube in esophageal position.
abstract: OBJECTIVE
  To compare plasma concentrations and cardiovascular effects of epinephrine after application via a conventional endotracheal airway and via the esophageal lumen of a new emergency airway, the esophageal tracheal Combitube.
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  Center for Biomedical Research, University of Vienna.
  
  
  METHODS
  Fourteen juvenile swine received either an endotracheal tube (Group A) or a Combitube in esophageal position (Group B).
  
  
  METHODS
  In Part I of the study, epinephrine was administered during spontaneous beating of the heart; in Part II, epinephrine was administered during cardiopulmonary resuscitation, using a ten-fold higher dosage in Group B, respectively.
  
  
  METHODS
  Plasma epinephrine levels were measured 1, 2, 3, 5, 7, 10, 15, and 30 mins after application. Systolic arterial blood pressure and cardiac output in Part I, and end-tidal CO2 and coronary perfusion pressure in Part II were recorded.
  
  
  RESULTS
  In Part I, increased levels of plasma epinephrine and systolic arterial pressure were maintained significantly longer in Group B when compared with Group A. In Part II, no significant differences between the groups were found with regard to plasma epinephrine levels and hemodynamic variables.
  
  
  CONCLUSIONS
  Epinephrine applied via the esophageal lumen of the Combitube in a ten-fold higher dosage has similar effects on plasma epinephrine levels and hemodynamic variables compared to endotracheal administration.
authors.affiliation: Department of Emergency Medicine, University of Vienna, School of Medicine, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Kofler
authors.forename: F
authors.initials: F
authors.lastname: Sterz
authors.forename: R
authors.initials: R
authors.lastname: Hofbauer
authors.forename: S
authors.initials: S
authors.lastname: Rödler
authors.forename: E
authors.initials: E
authors.lastname: Schuster
authors.forename: M
authors.initials: M
authors.lastname: Winkler
authors.forename: I
authors.initials: I
authors.lastname: Schwendenwein
authors.forename: U
authors.initials: U
authors.lastname: Losert
authors.forename: C
authors.initials: C
authors.lastname: Bieglmayer
authors.forename: J L
authors.initials: JL
authors.lastname: Benumof
authors.forename: M
authors.initials: M
authors.lastname: Frass
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D016887:Cardiopulmonary Resuscitation; D004305:Dose-Response Relationship, Drug; D004837:Epinephrine / Q000008:administration & dosage* / Q000097:blood; D004947:Esophagus; D005260:Female; D007440:Intubation / Q000295:instrumentation*; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D013552:Swine
chemical_list: D004837:Epinephrine