Supplement of levosimendan to epinephrine improves initial resuscitation outcomes from asphyxial cardiac arrest.
BACKGROUND
Levosimendan exerted favorable effects on the initial outcome in the treatment of ventricular fibrillation cardiac arrest. This study investigated the efficacy of levosimendan in the treatment of asphyxia-induced cardiac arrest in rats.


METHODS
Animals underwent asphyxial cardiac arrest/cardiopulmonary resuscitation, randomized to three treatment groups: epinephrine (10 μg/kg) supplemented with levosimendan (bolus 12 μg/kg and infusion for 1 h, EL group); epinephrine only (10 μg/kg, E group), or levosimendan only (bolus 12 μg/kg and infusion for 1 h, L group). The resuscitation success rate, wet-to-dry ratio of lung, and rate of alveolar and blood gas analysis were recorded.


RESULTS
10 rats in the EL group, 8 in the E group, and 2 in the L group showed an initial return of spontaneous circulation (P < 0.001); among them, 10, 4, and 2 rats survived at the end of a 60-min observation period from each group, respectively (P = 0.001). The coronary perfusion pressure in the EL group was higher than that of either the E or L group (P < 0.05). The lung wet-to-dry weight ratio and rate of damaged alveoli were lower in the EL group than the E group (P < 0.05).


CONCLUSIONS
In the early stage of resuscitation for asphyxia-induced cardiac arrest in rats, levosimendan supplemented with epinephrine can significantly increase coronary perfusion pressure, reduce lung injury, and ultimately enhance the survival rate.
Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
Bingjing
B
Wu
Department of Anesthesiology, College of Medicine, University of Florida Shands Hospital, Gainesville, FL, USA.
Yong G
YG
Peng
Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
Shishi
S
Zhao
Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
Nana
N
Bao
Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
Linmin
L
Pan
Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
Jiaojiao
J
Dong
Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China. xuzhong@263.net.|The First Affiliated Hospital, Wenzhou Medical University, South Baixiang Rd, Wenzhou City, Zhejiang Province, 325000, China. xuzhong@263.net.
Xuzhong
X
Xu
Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China. quanguangwang@sina.com.|The First Affiliated Hospital, Wenzhou Medical University, South Baixiang Rd, Wenzhou City, Zhejiang Province, 325000, China. quanguangwang@sina.com.
Quanguang
Q
Wang
D055371:Acute Lung Injury / Q000473:pathology / Q000517:prevention & control; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001237:Asphyxia / Q000209:etiology / Q000628:therapy; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D003326:Coronary Circulation / Q000187:drug effects; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage*; D006324:Heart Arrest, Induced; D006835:Hydrazones / Q000008:administration & dosage*; D008168:Lung / Q000473:pathology; D011724:Pyridazines / Q000008:administration & dosage*; D017207:Rats, Sprague-Dawley; D012151:Resuscitation / Q000379:methods*; D000077464:Simendan
D000889:Anti-Arrhythmia Agents; D001993:Bronchodilator Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004837:Epinephrine
Asphyxia; CPR; Cardiac arrest; Epinephrine; Levosimendan