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A Comparison of Etanercept vs. Infliximab for the Treatment of Post-Arrest Myocardial Dysfunction in a Swine Model of Ventricular Fibrillation.
MedLine Citation:
PMID:  23313857     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: To compare the effects of two TNF-α antagonists, etanercept and infliximab, on post-cardiac arrest haemodynamics and global left ventricular function (LV) in a swine model following ventricular fibrillation (VF) METHODS: Domestic swine (n=30) were placed under general anaesthesia and instrumented before VF was induced electrically. After 7minutes of VF, standard ACLS resuscitation was performed. Animals achieving return of spontaneous circulation (ROSC) were randomized to immediately receive infliximab (5mg/kg, n=10) or etanercept (0.3mg/kg [4mg/m(2)], n=10) or vehicle (250mL normal saline [NS], n=10) and LV function and haemodynamics were monitored for 3hours RESULTS: Following ROSC, mean arterial pressure (MAP), stroke work (SW), and LV dP/dt fell from prearrest values in all groups. However, at the 30minute nadir, infliximab-treated animals had higher MAP than either the NS group (difference 14.4mm Hg, 95% confidence interval [CI] 4.2-24.7) or the etanercept group (19.2mm Hg, 95% CI 9.0-29.5), higher SW than the NS group (10.3 gm-m, 95% CI 5.1-15.5) or the etanercept group (8.9 gm-m, 95% CI 4.0-14.4) and greater LV dP/dt than the NS group (282.9mm Hg/sec, 95% CI 169.6-386.1 higher with infliximab) or the etanercep group (228.9mm Hg/sec, 95% CI 115.6-342.2 higher with infliximab). CONCLUSIONS: Only infliximab demonstrated a beneficial effect on post cardiac arrest haemodynamics and LV function in this swine model. Etanercept was no better in this regard than saline.
Authors:
Scott T Youngquist; James T Niemann; Atman P Shah; Joseph L Thomas; John P Rosborough
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-9
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier Ireland Ltd.
Affiliation:
Department of Surgery, Division of Emergency Medicine, the University of Utah, Salt Lake, UT. Electronic address: scott.youngquist@utah.edu.
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