title: Effects of early amiodarone administration during and immediately after cardiopulmonary resuscitation in a swine model.
abstract: BACKGROUND
  Aim of this experimental study was to compare haemodynamic effects and outcome with early administration of amiodarone and adrenaline vs. adrenaline alone in pigs with prolonged ventricular fibrillation (VF).
  
  
  METHODS
  After 8 min of untreated VF arrest, bolus doses were administered of adrenaline (0.02 mg/kg) and either amiodarone (5 mg/kg) or saline (n = 8 per group) after randomisation. Cardiopulmonary resuscitation (CPR) was commenced immediately after drug administration, and defibrillation was attempted 2 min later. CPR was resumed for another 2 min after each defibrillation attempt, and the same dose of adrenaline was given every 4th minute during CPR. Haemodynamic monitoring and mechanical ventilation continued for 6 h after return of spontaneous circulation (ROSC), and the pigs were euthanised at 48 h. Researchers were blinded for drug groups throughout the study.
  
  
  RESULTS
  There was no difference in rates of ROSC and 48-h survival with amiodarone vs. saline (5/8 vs. 7/8 and 0/8 vs. 3/8, respectively). Diastolic aortic pressure and coronary perfusion pressure were significantly lower with amiodarone during CPR and 1 min after ROSC (P < 0.05). The number of electric shocks required for terminating VF, time to ROSC and adrenaline dose were significantly higher with amiodarone (P < 0.01). The incidence of post-resuscitation tachyarrhythmias tended to be higher in the saline group (P = 0.081).
  
  
  CONCLUSIONS
  Early administration of amiodarone did not improve ROSC or 48-h survival rates, and was associated with worse haemodynamics in this swine model of cardiac arrest.
authors.affiliation: 2nd Department of Internal Medicine, Sismanoglio General Hospital, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Karlis
authors.forename: N
authors.initials: N
authors.lastname: Iacovidou
authors.forename: P
authors.initials: P
authors.lastname: Lelovas
authors.forename: P
authors.initials: P
authors.lastname: Niforopoulou
authors.forename: A
authors.initials: A
authors.lastname: Zacharioudaki
authors.forename: A
authors.initials: A
authors.lastname: Papalois
authors.forename: K
authors.initials: K
authors.lastname: Sunde
authors.forename: P A
authors.initials: PA
authors.lastname: Steen
authors.forename: T
authors.initials: T
authors.lastname: Xanthos
mesh_terms: D000638:Amiodarone / Q000627:therapeutic use*; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004554:Electric Countershock; D004837:Epinephrine / Q000494:pharmacology; D005260:Female; D006323:Heart Arrest / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D016017:Odds Ratio; D012121:Respiration, Artificial; D012151:Resuscitation; D012769:Shock / Q000209:etiology / Q000628:therapy; D013552:Swine; D014662:Vasoconstrictor Agents / Q000494:pharmacology
chemical_list: D000889:Anti-Arrhythmia Agents; D014662:Vasoconstrictor Agents; D000638:Amiodarone; D004837:Epinephrine