title: Effects of terlipressin and naloxone compared with epinephrine in a rat model of asphyxia-induced cardiac arrest.
abstract: OBJECTIVE
  To evaluate the hemodynamic and metabolic effects of terlipressin and naloxone in cardiac arrest.
  
  
  METHODS
  Cardiac arrest in rats was induced by asphyxia and maintained for 3.5 minutes. Animals were then resuscitated and randomized into one of six groups: placebo (n = 7), epinephrine (0.02 mg/kg; n = 7), naloxone (1 mg/kg; n = 7) or terlipressin, of which three different doses were tested: 50 µg/kg (TP50; n = 7), 100 µg/kg (TP100; n = 7) and 150 µg/kg (TP150; n = 7). Hemodynamic variables were measured at baseline and at 10 (T10), 20 (T20), 30 (T30), 45 (T45) and 60 (T60) minutes after cardiac arrest. Arterial blood samples were collected at T10, T30 and T60.
  
  
  RESULTS
  The mean arterial pressure values in the TP50 group were higher than those in the epinephrine group at T10 (165 vs. 112 mmHg), T20 (160 vs. 82 mmHg), T30 (143 vs. 66 mmHg), T45 (119 vs. 67 mmHg) and T60 (96 vs. 66.8 mmHg). The blood lactate level was lower in the naloxone group than in the epinephrine group at T10 (5.15 vs. 10.5 mmol/L), T30 (2.57 vs. 5.24 mmol/L) and T60 (2.1 vs. 4.1 mmol/L).
  
  
  CONCLUSIONS
  In this rat model of asphyxia-induced cardiac arrest, terlipressin and naloxone were effective vasopressors in cardiopulmonary resuscitation and presented better metabolic profiles than epinephrine. Terlipressin provided better hemodynamic stability than epinephrine.
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Department of Emergency Medicine, Research Laboratory, São PauloSP, Brazil.
authors.forename: Herlon S
authors.initials: HS
authors.lastname: Martins
authors.forename: Márcia K
authors.initials: MK
authors.lastname: Koike
authors.forename: Irineu T
authors.initials: IT
authors.lastname: Velasco
mesh_terms: D000818:Animals; D062186:Arterial Pressure / Q000187:drug effects; D001237:Asphyxia / Q000150:complications; D016887:Cardiopulmonary Resuscitation; D004837:Epinephrine / Q000378:metabolism / Q000494:pharmacology*; D006323:Heart Arrest / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D008236:Lypressin / Q000031:analogs & derivatives* / Q000378:metabolism / Q000494:pharmacology; D008297:Male; D023421:Models, Animal; D009270:Naloxone / Q000378:metabolism / Q000494:pharmacology*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012016:Reference Values; D015203:Reproducibility of Results; D000077585:Terlipressin; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000378:metabolism / Q000494:pharmacology*
chemical_list: D014662:Vasoconstrictor Agents; D009270:Naloxone; D008236:Lypressin; D000077585:Terlipressin; D004837:Epinephrine
references.citation: Crit Care Med. 2007 Sep;35(9):2145-9
references.pmid: 17855828
references.citation: Acta Anaesthesiol Scand. 2006 Oct;50(9):1125-30
references.pmid: 16987343
references.citation: Crit Care Med. 2009 Apr;37(4):1408-15
references.pmid: 19242339
references.citation: Acta Anaesthesiol Scand. 2006 Nov;50(10):1271-6
references.pmid: 17067328
references.citation: J Emerg Med. 2010 Sep;39(3):296-300
references.pmid: 19264439
references.citation: Crit Care Med. 2001 Mar;29(3):623-7
references.pmid: 11373431
references.citation: Br J Pharmacol. 2010 Aug;160(7):1573-6
references.pmid: 20649560
references.citation: Resuscitation. 1997 Jun;34(3):255-61
references.pmid: 9178387
references.citation: Resuscitation. 2011 Sep;82(9):1138-43
references.pmid: 21745533
references.citation: Br J Anaesth. 2008 Apr;100(4):494-503
references.pmid: 18308741
references.citation: Crit Care Med. 1996 Oct;24(10):1695-700
references.pmid: 8874308
references.citation: Crit Care Med. 1999 Sep;27(9):1929-33
references.pmid: 10507620
references.citation: Circ Cardiovasc Qual Outcomes. 2010 Jan;3(1):63-81
references.pmid: 20123673
references.citation: Resuscitation. 2006 Jan;68(1):151-3
references.pmid: 16325320
references.citation: Am J Emerg Med. 2008 Jan;26(1):113.e5-8
references.pmid: 18082805
references.citation: Crit Care Med. 1994 Feb;22(2):282-90
references.pmid: 8306688
references.citation: Resuscitation. 2010 Jan;81(1):42-6
references.pmid: 19913979
references.citation: Neurosci Lett. 2000 Jun 23;287(2):113-6
references.pmid: 10854725
references.citation: Resuscitation. 1996 Nov;33(1):69-84
references.pmid: 8959776
references.citation: Intensive Care Med. 2010 Jul;36(7):1248-55
references.pmid: 20237762
references.citation: Ann Pharmacother. 2010 Oct;44(10):1545-53
references.pmid: 20841511
references.citation: Pediatr Crit Care Med. 2010 Jan;11(1):139-41
references.pmid: 19581820
references.citation: Crit Care Med. 2009 Mar;37(3):876-81
references.pmid: 19237891
references.citation: Circulation. 1988 Aug;78(2):382-9
references.pmid: 3396175
references.citation: Circ Shock. 1985;16(4):347-61
references.pmid: 3836027
references.citation: Circulation. 2010 Nov 2;122(18 Suppl 3):S676-84
references.pmid: 20956220
references.citation: Life Sci. 1998;63(14):1205-19
references.pmid: 9771910
references.citation: Crit Care Med. 1993 Jul;21(7):1046-50
references.pmid: 8319463
references.citation: Crit Care Med. 2007 Apr;35(4):1161-4
references.pmid: 17312566
references.citation: Crit Care Med. 2010 Jan;38(1):101-8
references.pmid: 19770741
references.citation: Resuscitation. 1996 Sep;32(2):109-10
references.pmid: 8896050
references.citation: Anesth Analg. 2006 Feb;102(2):542-8
references.pmid: 16428558
references.citation: Anaesthesia. 1985 Aug;40(8):819
references.pmid: 4037279
references.citation: Resuscitation. 2000 Aug 1;45(3):161-6
references.pmid: 10959014
references.citation: Rev Bras Anestesiol. 2011 Nov-Dec;61(6):728-35
references.pmid: 22063374
references.citation: Am J Emerg Med. 2008 Oct;26(8):898-901
references.pmid: 18926348
references.citation: Am J Physiol. 1990 Aug;259(2 Pt 2):H504-11
references.pmid: 2201209
references.citation: Am J Emerg Med. 2006 Sep;24(5):567-72
references.pmid: 16938595