Simultaneous blockade of alpha1- and beta-actions of epinephrine during cardiopulmonary resuscitation.
OBJECTIVE
Experimental and clinical studies have implicated that alpha1- and beta-adrenergic effects of epinephrine significantly increased the severity of postresuscitation myocardial dysfunction by increasing myocardial oxygen consumption during ventricular fibrillation. This prompted experimental studies to investigate the effect of simultaneous blockade of alpha1- and beta-actions of epinephrine during cardiopulmonary resuscitation.


METHODS
Literature review.


RESULTS
Improved postresuscitation myocardial dysfunction was observed in epinephrine-treated animals after its alpha1- and beta-actions were blocked, which were associated with less postresuscitation arrhythmia, lower blood lactate level, better neurologic recovery, and longer duration of survival.


CONCLUSIONS
After simultaneous alpha1- and beta-adrenergic blockade, epinephrine administered during cardiopulmonary resuscitation yielded improved postresuscitation myocardial functions and significantly better postresuscitation outcomes.
Huang
Lei
L
Weil Institute of Critical Care Medicine, Rancho Mirage, California, USA.
Sun
Shije
S
Fang
Xiangshao
X
Tang
Wanchun
W
Weil
Max Harry
MH
D058668:Adrenergic alpha-1 Receptor Antagonists; D058647:Adrenergic alpha-2 Receptor Agonists; D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects; D004837:Epinephrine / Q000494:pharmacology*; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy; D014693:Ventricular Fibrillation / Q000503:physiopathology / Q000628:therapy
D058668:Adrenergic alpha-1 Receptor Antagonists; D058647:Adrenergic alpha-2 Receptor Agonists; D000319:Adrenergic beta-Antagonists; D004837:Epinephrine