Landiolol, an ultra short acting beta1-blocker, improves pulmonary edema after cardiopulmonary resuscitation with epinephrine in rats.
OBJECTIVE
Epinephrine is frequently administered as an essential drug for cardiopulmonary resuscitation (CPR) in clinical situations. Unfortunately, epinephrine elicits unfavorable effects, for example pulmonary edema, both during and after CPR. We hypothesized that administration of landiolol during CPR with epinephrine would reduce the degree of pulmonary edema and improve survival. Therefore using a rat CPR model, we investigated the effect of landiolol with epinephrine on pulmonary and cardiac injury following CPR.


METHODS
Twelve male Sprague-Dawley rats were allocated to Group-E (Gr.-E: 0.02 mg/kg epinephrine) and thirteen animals to Group-EL (Gr.-EL: 0.02 mg/kg epinephrine with 0.5 mg/kg landiolol). After tracheotomy, cardiac arrest was induced by obstructing the endotracheal tube. We measured the lung wet-to-dry (W/D) weight ratio to evaluate the degree of pulmonary edema 2 h after CPR. The hematocrit (Hct) difference between before and after CPR (Hct-D) was calculated. We measured the plasma levels of troponin-I (T-I) to evaluate the degree of cardiac injury.


RESULTS
The lung W/D weight ratio in Gr.-E (6.4 +/- 1.06, mean +/- SD) was significantly higher than that for Gr.-EL (4.9 +/- 0.80, p < 0.01). Hct-D was significantly higher in Gr.-E (10.2 +/- 3.1%) than in Gr.-EL (5.2 +/- 3.5%, p < 0.01). We observed no difference in survival or difference of T-I. (Gr.-E: 2.62 +/- 0.51 ng/ml, Gr.-EL: 3.43 +/- 2.72 ng/ml).


CONCLUSIONS
Administration of landiolol during CPR with epinephrine prevented the development of pulmonary edema and the increase in Hct during and after CPR.
Uraoka
Masahiro
M
Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan. uraura@hama-med.ac.jp.
Nakajima
Yoshiki
Y
Kurita
Tadayoshi
T
Suzuki
Akira
A
Takata
Kotaro
K
Sato
Shigehito
S
D000136:Acid-Base Equilibrium; D000316:Adrenergic alpha-Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D058671:Adrenergic beta-1 Receptor Antagonists; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000818:Animals; D001835:Body Weight / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D016887:Cardiopulmonary Resuscitation; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000009:adverse effects* / Q000627:therapeutic use; D006400:Hematocrit; D008168:Lung / Q000187:drug effects / Q000473:pathology; D008297:Male; D009025:Morpholines / Q000627:therapeutic use*; D009929:Organ Size / Q000187:drug effects; D010100:Oxygen / Q000097:blood; D011654:Pulmonary Edema / Q000139:chemically induced / Q000517:prevention & control*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013997:Time Factors; D019210:Troponin I / Q000097:blood; D014508:Urea / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000316:Adrenergic alpha-Agonists; D058671:Adrenergic beta-1 Receptor Antagonists; D000319:Adrenergic beta-Antagonists; D009025:Morpholines; D019210:Troponin I; D002245:Carbon Dioxide; C077049:landiolol; D014508:Urea; D010100:Oxygen; D004837:Epinephrine