title: 2,3-Butanedione monoxime facilitates successful resuscitation in a dose-dependent fashion in a pig model of cardiac arrest.
abstract: OBJECTIVE
  Ischemic contracture compromises the hemodynamic effectiveness of cardiopulmonary resuscitation (CPR) and resuscitability from cardiac arrest. In a pig model of cardiac arrest, 2,3-butanedione monoxime (BDM) attenuated ischemic contracture. We investigated the effects of different doses of BDM to determine whether increasing the dose of BDM could improve the hemodynamic effectiveness of CPR further, thus ultimately improving resuscitability.
  
  
  METHODS
  After 16minutes of untreated ventricular fibrillation and 8minutes of basic life support, 36 pigs were divided randomly into 3 groups that received 50mg/kg (low-dose group) of BDM, 100mg/kg (high-dose group) of BDM, or an equivalent volume of saline (control group) during advanced cardiovascular life support.
  
  
  RESULTS
  During advanced cardiovascular life support, the control group showed an increase in left ventricular (LV) wall thickness and a decrease in LV chamber area. In contrast, the BDM-treated groups showed a decrease in the LV wall thickness and an increase in the LV chamber area in a dose-dependent fashion. Mixed-model analyses of the LV wall thickness and LV chamber area revealed significant group effects and group-time interactions. Central venous oxygen saturation at 3minutes after the drug administration was 21.6% (18.4-31.9), 39.2% (28.8-53.7), and 54.0% (47.5-69.4) in the control, low-dose, and high-dose groups, respectively (P<.001). Sustained restoration of spontaneous circulation was attained in 7 (58.3%), 10 (83.3%), and 12 animals (100%) in the control, low-dose, and high-dose groups, respectively (P=.046).
  
  
  CONCLUSIONS
  2,3-Butanedione monoxime administered during CPR attenuated ischemic contracture and improved the resuscitability in a dose-dependent fashion.
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju, Republic of Korea.
authors.forename: Byung Kook
authors.initials: BK
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Songjeong Sarang Hospital, 232 Songdo-ro, Gwangsangu, Gwangju, Republic of Korea.
authors.forename: Mu Jin
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju, Republic of Korea. Electronic address: neoneti@hanmail.net.
authors.forename: Kyung Woon
authors.initials: KW
authors.lastname: Jeung
authors.affiliation: Department of Emergency Medical Service, Howon University, 64 Howondae 3gil, Gunsan, Jeollabuk-do, Republic of Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Choi
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju, Republic of Korea.
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Emergency Medical Technology, Namseoul university, 91 Daehak-ro, Seonghwan-eup, Sebuk-gu, Cheonan, Republic of Korea.
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Yun
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju, Republic of Korea.
authors.forename: Sung Min
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju, Republic of Korea.
authors.forename: Dong Hun
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju, Republic of Korea.
authors.forename: Yong Il
authors.initials: YI
authors.lastname: Min
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation; D003931:Diacetyl / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D054061:Ischemic Contracture / Q000209:etiology / Q000517:prevention & control*; D013552:Swine; D014693:Ventricular Fibrillation / Q000150:complications; D016277:Ventricular Function, Left
chemical_list: D004791:Enzyme Inhibitors; C004717:diacetylmonoxime; D003931:Diacetyl