Document Detail

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:  MEDLINE    
AIMS: To compare the effects of two TNF-α antagonists, etanercept and infliximab, on post-cardiac arrest hemodynamics and global left ventricular function (LV) in a swine model following ventricular fibrillation (VF).
METHODS: Domestic swine (n=30) were placed under general anesthesia and instrumented before VF was induced electrically. After 7 min of VF, standard ACLS resuscitation was performed. Animals achieving return of spontaneous circulation (ROSC) were randomized to immediately receive infliximab (5 mg/kg, n=10) or etanercept (0.3 mg/kg [4 mg/m(2)], n=10) or vehicle (250 mL normal saline [NS], n=10) and LV function and hemodynamics were monitored for 3 h.
RESULTS: Following ROSC, mean arterial pressure (MAP), stroke work (SW), and LV dP/dt fell from pre-arrest values in all groups. However, at the 30 min nadir, infliximab-treated animals had higher MAP than either the NS group (difference 14.4 mm Hg, 95% confidence interval [CI] 4.2-24.7) or the etanercept group (19.2 mm 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 (282.9 mm Hg/s, 95% CI 169.6-386.1 higher with infliximab) or the etanercep group (228.9 mm Hg/s, 95% CI 115.6-342.2 higher with infliximab).
CONCLUSIONS: Only infliximab demonstrated a beneficial effect on post cardiac arrest hemodynamics and LV function in this swine model. Etanercept was no better in this regard than saline.
Scott T Youngquist; James T Niemann; Atman P Shah; Joseph L Thomas; John P Rosborough
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2013-01-09
Journal Detail:
Title:  Resuscitation     Volume:  84     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-10     Completed Date:  2014-02-20     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  999-1003     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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MeSH Terms
Anti-Inflammatory Agents, Non-Steroidal / pharmacology*
Antibodies, Monoclonal / pharmacology*
Blood Pressure / drug effects
Disease Models, Animal
Heart Arrest, Induced
Immunoglobulin G / pharmacology*
Random Allocation
Receptors, Tumor Necrosis Factor
Tumor Necrosis Factor-alpha
Ventricular Fibrillation / drug therapy*
Ventricular Function, Left / drug effects*
Grant Support
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Antibodies, Monoclonal; 0/Immunoglobulin G; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 0/infliximab; 185243-69-0/TNFR-Fc fusion protein

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