Ventricular fibrillation median frequency may not be useful for monitoring during cardiac arrest treated with endothelin-1 or epinephrine.
In this study, we evaluated whether median fibrillation frequency (MF) and mean fibrillation amplitude (AMP) reflect coronary perfusion pressure (CoPP) and predict successful defibrillation. MF, AMP, and CoPP were measured during prolonged ventricular fibrillation (VF) cardiac arrest and resuscitation in pigs. After 5 min of VF, cardiopulmonary resuscitation was started. At 10 min, the pigs received randomly a single dose of endothelin-1 50 mug (n = 7), 100 mug (n = 7), or 200 mug (n = 5), or repeated doses of epinephrine 0.04 mg/kg (n = 6), or saline (n = 6) every 3 min. At 25 min, the pigs were defibrillated to achieve restoration of spontaneous circulation (ROSC). In a nonparametric spectral analysis of the individual MF versus CoPP and AMP versus CoPP curves, we found no link between the different curves in different animals or therapies. No difference was found in MF in pigs with ROSC (n = 8) compared with animals not achieving ROSC (n = 23) immediately before defibrillation (P = 0.85). Our data suggest that, in prolonged VF cardiac arrest, MF and AMP might not be useful tools to reflect myocardial perfusion.
Holzer
Michael
M
Departments of *Emergency Medicine and †Medical Computer Sciences, University of Vienna, Vienna, Austria.
Behringer
Wilhelm
W
Sterz
Fritz
F
Kofler
Julia
J
Oschatz
Elisabeth
E
Schuster
Ernst
E
Laggner
Anton N
AN
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use*; D000818:Animals; D016887:Cardiopulmonary Resuscitation; D003326:Coronary Circulation / Q000187:drug effects; D004554:Electric Countershock; D004562:Electrocardiography / Q000187:drug effects*; D019332:Endothelin-1 / Q000627:therapeutic use*; D004837:Epinephrine / Q000627:therapeutic use*; D005260:Female; D006323:Heart Arrest / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008991:Monitoring, Physiologic; D012121:Respiration, Artificial; D013552:Swine; D014693:Ventricular Fibrillation / Q000150:complications / Q000503:physiopathology*
D000316:Adrenergic alpha-Agonists; D019332:Endothelin-1; D004837:Epinephrine