Document Detail


Effect of vasopressin on postresuscitation ventricular function: unknown consequences of the recent Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
MedLine Citation:
PMID:  15508667     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the effect on postresuscitation left ventricular function of vasopressin vs. epinephrine used during cardiopulmonary resuscitation in a swine model of prolonged prehospital ventricular fibrillation. DESIGN: Prospective, randomized experimental study. SETTING: University large animal resuscitation research laboratory. SUBJECTS: Forty-eight swine (29 +/- 1 kg). INTERVENTIONS: Resuscitation after 12.5 mins of untreated ventricular fibrillation, randomizing animals during cardiopulmonary resuscitation to treatment with epinephrine, vasopressin, or vasopressin followed by a vasopressin antagonist administered in the postresuscitation period. MEASUREMENTS AND MAIN RESULTS: Serial measurements of left ventricular systolic and diastolic function (prearrest, postresuscitation at 30 mins and 6 hrs) and 24-hr survival. Animals receiving vasopressin had more postresuscitation left ventricular dysfunction than those receiving epinephrine (p < .05). The vasopressin antagonist produced vasodilation and improved early postresuscitation left ventricular systolic and diastolic function but did not have a lasting effect on such postresuscitation ventricular function and decreased 24-hr survival compared with the use of vasopressin alone (3/16 vs. 10/16 survivors; p < .05). CONCLUSIONS: Vasopressin use during cardiopulmonary resuscitation results in worse postresuscitation left ventricular function early but did not compromise 24-hr outcome. Reversal of vasopressin's effect with a specific V-1 antagonist in the postresuscitation period did not improve survival.
Authors:
Karl B Kern; Joseph H Heidenreich; Travis A Higdon; Robert A Berg; Ronald W Hilwig; Arthur B Sanders; Nathan Anavy; Gordon A Ewy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  32     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-10-28     Completed Date:  2004-11-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S393-7     Citation Subset:  AIM; IM    
Affiliation:
University of Arizona College of Medicine, Sarver Heart Center, Tucson, AZ, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiopulmonary Resuscitation / methods*
Emergency Medical Services / methods*
Epinephrine / pharmacology*
Female
Heart Arrest / drug therapy*
Male
Practice Guidelines as Topic
Swine
Vasoconstrictor Agents / pharmacology*
Vasopressins / pharmacology*
Ventricular Function, Left / drug effects*
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; 11000-17-2/Vasopressins; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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