| Title | Vasopressin improves vital organ blood flow after prolonged cardiac arrest with postcountershock pulseless electrical activity in pigs. | | Author(s) | Wenzel V, Lindner KH, Prengel AW, Maier C, Voelckel W, Lurie KG, Strohmenger HU | | Institution | Department of Anesthesiology, University of Ulm, Germany. | | Source | Crit Care Med 1999 Mar; 27(3):486-92. | | MeSH | Animals
Cerebrovascular Circulation
Comparative Study
Coronary Circulation
Electric Countershock
Epinephrine
Heart Arrest
Hemodynamic Processes
Prospective Studies
Random Allocation
Research Support, Non-U.S. Gov't
Resuscitation
Swine
Time Factors
Vasoconstrictor Agents
Vasopressins
| | Abstract | OBJECTIVE: Although a benefit of vasopressin when compared with epinephrine was shown during cardiopulmonary resuscitation (CPR) after a short duration of ventricular fibrillation cardiac arrest, the effect of vasopressin during prolonged cardiac arrest with pulseless electrical activity is currently unknown.
DESIGN: Prospective, randomized laboratory investigation using an established porcine model with instrumentation for measurement of hemodynamic variables, vital organ blood flow, blood gases, and return of spontaneous circulation.
SETTING: University hospital laboratory.
SUBJECTS: Eighteen domestic pigs.
INTERVENTIONS: After 15 mins of cardiac arrest and 3 mins of chest compressions, 18 animals were randomly treated with either 0.8 units/kg vasopressin (n = 9) or 200 microg/kg epinephrine (n = 9).
MEASUREMENTS AND MAIN RESULTS: Compared with epinephrine, vasopressin resulted, at both 90 secs and 5 mins after drug administration, in significantly higher (p < .05) median (25th-75th percentiles) left ventricular myocardial blood flow (120 [range, 96-193] vs. 54 [range, 11-92] and 56 [range, 41-80] vs. 21 [range, 11-40] mL/min/100 g, respectively) and total cerebral blood flow (85 [78-102] vs. 24 [18-41] and 50 [44-52] vs. 8 [5-23] mL/min/100 g, respectively). Spontaneous circulation was restored in eight of nine animals in the vasopressin group and in one of nine animals in the epinephrine group (p = .003).
CONCLUSIONS: Compared with a maximum dose of epinephrine, vasopressin significantly increased left ventricular myocardial and total cerebral blood flow during CPR and return of spontaneous circulation in a porcine model of prolonged cardiac arrest with postcountershock pulseless electrical activity. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 10199526 |
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