Vasopressin and epinephrine in the treatment of cardiac arrest: an experimental study.
BACKGROUND
Epinephrine remains the drug of choice for cardiopulmonary resuscitation. The aim of the present study is to assess whether the combination of vasopressin and epinephrine, given their different mechanisms of action, provides better results than epinephrine alone in cardiopulmonary resuscitation.


METHODS
Ventricular fibrillation was induced in 22 Landrace/Large-White piglets, which were left untreated for 8 minutes before attempted resuscitation with precordial compression, mechanical ventilation and electrical defibrillation. Animals were randomized into 2 groups during cardiopulmonary resuscitation: 11 animals who received saline as placebo (20 ml dilution, bolus) + epinephrine (0.02 mg/kg) (Epi group); and 11 animals who received vasopressin (0.4 IU/kg/20 ml dilution, bolus) + epinephrine (0.02 mg/kg) (Vaso-Epi group). Electrical defibrillation was attempted after 10 minutes of ventricular fibrillation.


RESULTS
Ten of 11 animals in the Vaso-Epi group restored spontaneous circulation in comparison to only 4 of 11 in the Epi group (p = 0.02). Aortic diastolic pressure, as well as, coronary perfusion pressure were significantly increased (p < 0.05) during cardiopulmonary resuscitation in the Vaso-Epi group.


CONCLUSIONS
The administration of vasopressin in combination with epinephrine during cardiopulmonary resuscitation results in a drastic improvement in the hemodynamic parameters necessary for the return of spontaneous circulation.
Stroumpoulis
Konstantinos
K
University of Athens, Medical School, Department of Experimental Surgery and Surgical Research, Agiou Thoma Street, Athens, Greece.
Xanthos
Theodoros
T
Rokas
Georgios
G
Kitsou
Vassiliki
V
Papadimitriou
Dimitrios
D
Serpetinis
Ioannis
I
Perrea
Despina
D
Papadimitriou
Lila
L
Kouskouni
Evangelia
E
D000704:Analysis of Variance; D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004837:Epinephrine / Q000494:pharmacology*; D006323:Heart Arrest / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics / Q000187:drug effects; D011897:Random Allocation; D018709:Statistics, Nonparametric; D013552:Swine; D014667:Vasopressins / Q000494:pharmacology*
D014667:Vasopressins; D004837:Epinephrine