Atenolol in combination with epinephrine improves the initial outcome of cardiopulmonary resuscitation in a swine model of ventricular fibrillation.
OBJECTIVE
The aim of the present study was to assess whether a beta-adrenergic blocking agent such as atenolol, administered during cardiopulmonary resuscitation, would improve initial resuscitation success.


METHODS
Ventricular fibrillation was induced in 20 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 (10 animals each) to receive saline as placebo (20 mL dilution, bolus) + epinephrine (0.02 mg/kg) (group A) or atenolol (0.05 mg/kg per 20 mL dilution, bolus) + epinephrine (0.02 mg/kg) (group B) during cardiopulmonary resuscitation. Electrical defibrillation was attempted after 10 minutes of ventricular fibrillation.


RESULTS
Nine animals in group B restored spontaneous circulation in comparison to only 4 in group A. Aortic systolic and diastolic pressures as well as coronary perfusion pressure were significantly increased during cardiopulmonary resuscitation in group B. Furthermore, postresuscitation heart rate of the atenolol-treated group was significantly decreased.


CONCLUSIONS
A beta-adrenergic blocking agent, when administered during cardiopulmonary resuscitation, significantly improves initial resuscitation success and increases blood and coronary perfusion pressures during cardiopulmonary resuscitation.
Bassiakou
Eleni
E
Department of Experimental Surgery and Surgical Research N.S.Christeas, Athens School of Medicine, Athens 11527, Greece.
Xanthos
Theodoros
T
Koudouna
Eleni
E
Goulas
Sotirios
S
Prapa
Vassiliki
V
Papadimitriou
Dimitrios
D
Rokas
George
G
Papadimitriou
Lila
L
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D001262:Atenolol / Q000008:administration & dosage / Q000627:therapeutic use*; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000592:standards; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics; D008297:Male; D023421:Models, Animal; D017410:Practice Guidelines as Topic; D011897:Random Allocation; D013552:Swine; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014693:Ventricular Fibrillation / Q000188:drug therapy*
D000319:Adrenergic beta-Antagonists; D014662:Vasoconstrictor Agents; D001262:Atenolol; D004837:Epinephrine