A comparison of transoesophageal cardiac pacing and epinephrine for cardiopulmonary resuscitation.
The use of cardiac pacing to deal with bradycardia is well established. There is debate as to the benefits during cardiopulmonary resuscitation (CPR). This study was performed to compare the effects of transoesophageal cardiac pacing and high-dose epinephrine on the benefits of cardiopulmonary resuscitation after asphyxial cardiac arrest in rats. Thirty Sprague-Dawley rats of both sexes were randomly selected to a saline group (Sal-gro, treated with normal saline 1 mL IV, n = 10), an epinephrine group (Epi-gro, treated with epinephrine 0.4 mg/kg IV, n = 10), or a pacing group (Pac-gro, treated with normal saline 1 mL IV combined with transoesophageal cardiac pacing, n = 10) in a blinded fashion during resuscitation after 10 minutes of asphyxial cardiac arrest. Manual chest compression was in all cases performed using the same methodology by the same personnel who was blinded to hemodynamic monitor tracings. The rate of restoration of spontaneous circulation was 1 (10%), 7 (70%), and 8 (80%) of 10 in Sal-gro, Epi-gro, and Pac-gro, respectively. The rate of ventilator withdrawal within 60 minutes after resuscitation in Pac-gro was higher than that of Epi-gro (8/8 vs 1/7, respectively; P = .001); the survival rate after 2 hours in Pac-gro was significantly higher than that in Epi-gro (7/8 vs 1/7, respectively; P = .01). The data demonstrate that both epinephrine and transoesophageal cardiac pacing are effective within 10 minutes of asphyxia in rats. It is worth noting that transoesophageal cardiac pacing produced a better outcome with respiration and longer survival time compared with epinephrine after restoration of spontaneous circulation.
Chen
Meng-Hua
MH
Institute of Cardiovascular Diseases, First Affiliated Hospital of Guangxi Medical University, Nanning 530027, PR China. cmhnn@sina.com
Liu
Tang-Wei
TW
Xie
Lu
L
Song
Feng-Qing
FQ
He
Tao
T
D000818:Animals; D001794:Blood Pressure; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000379:methods*; D004195:Disease Models, Animal; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D004837:Epinephrine / Q000627:therapeutic use*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006339:Heart Rate; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function; D013566:Sympathomimetics / Q000627:therapeutic use*; D016896:Treatment Outcome
D013566:Sympathomimetics; D004837:Epinephrine