title: Effect of vasopressin on postresuscitation ventricular function: unknown consequences of the recent Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
abstract: OBJECTIVE
  To compare the effect on postresuscitation left ventricular function of vasopressin vs. epinephrine used during cardiopulmonary resuscitation in a swine model of prolonged prehospital ventricular fibrillation.
  
  
  METHODS
  Prospective, randomized experimental study.
  
  
  METHODS
  University large animal resuscitation research laboratory.
  
  
  METHODS
  Forty-eight swine (29 +/- 1 kg).
  
  
  METHODS
  Resuscitation after 12.5 mins of untreated ventricular fibrillation, randomizing animals during cardiopulmonary resuscitation to treatment with epinephrine, vasopressin, or vasopressin followed by a vasopressin antagonist administered in the postresuscitation period.
  
  
  RESULTS
  Serial measurements of left ventricular systolic and diastolic function (prearrest, postresuscitation at 30 mins and 6 hrs) and 24-hr survival. Animals receiving vasopressin had more postresuscitation left ventricular dysfunction than those receiving epinephrine (p < .05). The vasopressin antagonist produced vasodilation and improved early postresuscitation left ventricular systolic and diastolic function but did not have a lasting effect on such postresuscitation ventricular function and decreased 24-hr survival compared with the use of vasopressin alone (3/16 vs. 10/16 survivors; p < .05).
  
  
  CONCLUSIONS
  Vasopressin use during cardiopulmonary resuscitation results in worse postresuscitation left ventricular function early but did not compromise 24-hr outcome. Reversal of vasopressin's effect with a specific V-1 antagonist in the postresuscitation period did not improve survival.
authors.affiliation: University of Arizona College of Medicine, Sarver Heart Center, Tucson, AZ, USA.
authors.forename: Karl B
authors.initials: KB
authors.lastname: Kern
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Heidenreich
authors.forename: Travis A
authors.initials: TA
authors.lastname: Higdon
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Hilwig
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Sanders
authors.forename: Nathan
authors.initials: N
authors.lastname: Anavy
authors.forename: Gordon A
authors.initials: GA
authors.lastname: Ewy
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D004837:Epinephrine / Q000494:pharmacology*; D005260:Female; D006323:Heart Arrest / Q000188:drug therapy*; D008297:Male; D017410:Practice Guidelines as Topic; D013552:Swine; D014662:Vasoconstrictor Agents / Q000494:pharmacology*; D014667:Vasopressins / Q000494:pharmacology*; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D014662:Vasoconstrictor Agents; D014667:Vasopressins; D004837:Epinephrine