title: Dantrolene versus amiodarone for cardiopulmonary resuscitation: a randomized, double-blinded experimental study.
abstract: Dantrolene was introduced for treatment of malignant hyperthermia. It also has antiarrhythmic properties and may thus be an alternative to amiodarone for the treatment of ventricular fibrillation (VF). Aim of this study was to compare the return of spontaneous circulation (ROSC) with dantrolene and amiodarone in a pig model of cardiac arrest. VF was induced in anesthetized pigs. After 8 min of untreated VF, chest compressions and ventilation were started and one of the drugs (amiodarone 5 mg kg-1, dantrolene 2.5 mg kg-1or saline) was applied. After 4 min of initial CPR, defibrillation was attempted. ROSC rates, hemodynamics and cerebral perfusion measurements were measured. Initial ROSC rates were 7 of 14 animals in the dantrolene group vs. 5 of 14 for amiodarone, and 3 of 10 for saline). ROSC persisted for the 120 min follow-up in 6 animals in the dantrolene group, 4 after amiodarone and 2 in the saline group (n.s.). Hemodynamics were comparable in both dantrolene group amiodarone group after obtaining ROSC. Dantrolene and amiodarone had similar outcomes in our model of prolonged cardiac arrest, However, hemodynamic stability was not significantly improved using dantrolene. Dantrolene might be an alternative drug for resuscitation and should be further investigated.
authors.affiliation: Department of Anesthesia and Intensive Care, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiesmann
authors.affiliation: Department of Anesthesia and Intensive Care, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
authors.forename: Dennik
authors.initials: D
authors.lastname: Freitag
authors.affiliation: Department of Anesthesia and Intensive Care, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dersch
authors.affiliation: Department of Orthopedic and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
authors.forename: Daphne
authors.initials: D
authors.lastname: Eschbach
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Irqsusi
authors.affiliation: Department of Anesthesia and Intensive Care, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Steinfeldt
authors.affiliation: Department of Anesthesia and Intensive Care, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
authors.forename: Hinnerk
authors.initials: H
authors.lastname: Wulf
authors.affiliation: Department of Anesthesia and Intensive Care, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Feldmann
mesh_terms: D000638:Amiodarone / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D001784:Blood Gas Analysis; D001921:Brain / Q000378:metabolism; D016887:Cardiopulmonary Resuscitation; D003620:Dantrolene / Q000494:pharmacology / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004311:Double-Blind Method; D004554:Electric Countershock; D006439:Hemodynamics / Q000187:drug effects; D009125:Muscle Relaxants, Central / Q000494:pharmacology / Q000627:therapeutic use*; D013552:Swine; D014693:Ventricular Fibrillation / Q000188:drug therapy* / Q000473:pathology
chemical_list: D009125:Muscle Relaxants, Central; D003620:Dantrolene; D000638:Amiodarone