Resuscitation from cardiac arrest with adrenaline/epinephrine or vasopressin: effects on intestinal mucosal tonometer pCO(2) during the postresuscitation period in rats.
BACKGROUND
The use of vasopressin instead of adrenaline/epinephrine during resuscitation improves vital organ perfusion, but the effects on mesenteric perfusion following successful resuscitation are not fully evaluated. The present study was designed to compare the effects of vasopressin and adrenaline/epinephrine, given to rats during resuscitation from ventricular fibrillation, on to mesenteric ischaemia, as determined by intestinal mucosal tonometer pCO(2) during the postresuscitation period.


RESULTS
Male Sprague-Dawley rats (n=28) were allocated randomly to receive vasopressin (0.8 U/kg) or adrenaline/epinephrine (90 microg/kg) after 5 min of ventricular fibrillation. Precordial chest compression was initiated 4 min after the start of ventricular fibrillation, continued for 4 min, and followed by defibrillation. Seven of 14 (vasopressin) and 12 of 14 (adrenaline/epinephrine) rats were successfully defibrillated (P=0.10, Fisher's exact test) and observed for 60 min. Intestinal mucosal tonometer pCO(2) measurements before cardiac arrest and 15, 30, and 60 min following return of spontaneous circulation were 47+/-3, 73+/-8, 63+/-7, and 56+/-6 mmHg in the vasopressin group and 48+/-5, 78+/-7, 67+/-6, and 62+/-6 mmHg in the adrenaline/epinephrine group (P<0.05 at 60 min between vasopressin and adrenaline/epinephrine). Right atrial hemoglobin oxygen saturations at these time points were 73+/-5, 51+/-12, 58+/-11, and 63+/-5% in the vasopressin group and 76+/-7, 44+/-10, 52+/-10 and 54+/-8% in the adrenaline/epinephrine group (P<0.05 at 60 min between vasopressin and adrenaline/epinephrine).


CONCLUSIONS
We conclude that in this rat model the administration of vasopressin instead of adrenaline/epinephrine for CPR tends to be associated with lower resuscitation success, but less mesenteric ischaemia during the postresuscitation period in successfully resuscitated rats.
Studer
Wolfgang
W
Department of Anesthesiology and Research, University of Basel, CH-4031 Basel, Switzerland. wolfgang.studer@ksli.ch
Wu
Xianren
X
Siegemund
Martin
M
Seeberger
Manfred
M
D000322:Adrenergic Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000818:Animals; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000032:analysis; D004837:Epinephrine / Q000009:adverse effects / Q000627:therapeutic use*; D006323:Heart Arrest / Q000188:drug therapy / Q000209:etiology; D007511:Ischemia / Q000209:etiology; D008297:Male; D008365:Manometry; D008643:Mesentery / Q000098:blood supply; D023421:Models, Animal; D051381:Rats; D017207:Rats, Sprague-Dawley; D012151:Resuscitation / Q000379:methods*; D014662:Vasoconstrictor Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014667:Vasopressins / Q000009:adverse effects / Q000627:therapeutic use*; D014693:Ventricular Fibrillation / Q000150:complications / Q000188:drug therapy*
D000322:Adrenergic Agonists; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D002245:Carbon Dioxide; D004837:Epinephrine