title: Cytidine diphosphate choline improves the outcome of cardiac arrest vs epinephrine in rat model.
abstract: OBJECTIVE
  Cytidine diphosphate choline (CDP-choline) is a cholinergic agent that can both stimulate the cholinergic pathway and increase blood pressure. We aimed to investigate the effects of CDP-choline on the outcome of cardiac arrest in comparison with epinephrine.
  
  
  METHODS
  This was a randomized prospective animal study. Cardiac arrest was induced by asphyxia in 45 rats. After 7 minutes of asphyxia, resuscitation was attempted. The rats were allocated to different groups treated with 2 mL/kg saline, 100 μg/kg epinephrine, or 250 mg/kg CDP-choline. The hemodynamic parameters were monitored for 2 hours after resuscitation, and cardiac function was evaluated by echocardiography 2 hours after resuscitation. The hearts were harvested at the end of monitoring for histologic evaluation.
  
  
  RESULTS
  Epinephrine and CDP-choline improved the rate of return of spontaneous circulation and blood pressure during cardiopulmonary resuscitation; however, postresuscitation cardiac function in the CDP-choline and placebo groups was better than in the epinephrine group. Compared with the epinephrine group, less myocardial and mitochondrial injury was observed by electron microscopy in the CDP-choline and placebo groups; the level of superoxide dismutase and malondialdehyde indicated less peroxidative injury in the CDP-choline and placebo groups. Cytidine diphosphate choline and placebo also preserved connexin 43 when compared with epinephrine.
  
  
  CONCLUSIONS
  When administered during resuscitation, CDP-choline increased the rate of return of spontaneous circulation similarly to epinephrine. In addition, it did not increase the severity of myocardial injury and postresuscitation myocardial dysfunction, whereas epinephrine appeared to be harmful.
authors.affiliation: West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Huang
authors.initials: H
authors.lastname: Yu
authors.forename: He
authors.initials: H
authors.lastname: Qing
authors.forename: Zhan
authors.initials: Z
authors.lastname: Lei
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D016887:Cardiopulmonary Resuscitation; D018678:Cholinergic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003566:Cytidine Diphosphate Choline / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004837:Epinephrine / Q000627:therapeutic use*; D005260:Female; D006323:Heart Arrest / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D018384:Oxidative Stress; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D016037:Single-Blind Method; D016896:Treatment Outcome; D014463:Ultrasonography; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D018678:Cholinergic Agents; D014662:Vasoconstrictor Agents; D003566:Cytidine Diphosphate Choline; D004837:Epinephrine