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.
Department of Experimental Surgery and Surgical Research N.S.Christeas, Athens School of Medicine, Athens 11527, Greece.
Eleni
E
Bassiakou
Theodoros
T
Xanthos
Eleni
E
Koudouna
Sotirios
S
Goulas
Vassiliki
V
Prapa
Dimitrios
D
Papadimitriou
George
G
Rokas
Lila
L
Papadimitriou
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