Document Detail


Potential risks of high-dose epinephrine for resuscitation from ventricular fibrillation in a porcine model.
MedLine Citation:
PMID:  8477024     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The arterial plasma concentrations and hemodynamic effects of epinephrine, 10 micrograms/kg, IV (group A, N = 8) and 50 micrograms/kg, IV (group B, N = 8) were compared in a porcine resuscitation model after 3 minutes of circulatory arrest induced by ventricular fibrillation. All animals in group A were successfully resuscitated after 4.9 +/- 2.8 minutes and 2.8 +/- 1.6 defibrillations. In group B, only 6 of 8 animals were successfully resuscitated after 6.3 +/- 1.1 minutes and 4.0 +/- 2.7 defibrillations (mean +/- SD). During CPR, cardiac output (CO), left ventricular systolic pressure (LVSP), and mean arterial pressure (MAP) were nearly identical in the groups. The hemodynamic situation during the first hour after restitution of spontaneous circulation in group B was characterized by a significantly higher heart rate, combined with significantly lower values for cardiac inotropy, CO, LVSP, and MAP compared to group A. Mean arterial peak epinephrine concentrations (group A 197 +/- 133 ng/mL, group B 1173 +/- 298 ng/mL) were approximately fivefold higher in group B. After resuscitation, plasma concentrations returned to baseline levels within 7 minutes in group A and 15 minutes in group B. Later hemodynamic differences between the groups are thereby attributed to a detrimental impact of high-dose epinephrine on the heart during resuscitation.
Authors:
U Hörnchen; C Lussi; J Schüttler
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  7     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-24     Completed Date:  1993-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  184-7     Citation Subset:  IM    
Affiliation:
Institute of Anesthesiology, University of Bonn, Germany.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Circulation / physiology
Blood Pressure / physiology
Cardiac Output / physiology
Cardiopulmonary Resuscitation*
Electric Countershock
Epinephrine / administration & dosage,  blood,  therapeutic use*
Female
Heart Arrest / physiopathology,  therapy
Heart Massage
Heart Rate / physiology
Male
Myocardial Contraction / physiology
Risk Factors
Single-Blind Method
Swine
Ventricular Fibrillation / physiopathology,  therapy*
Ventricular Function, Left / physiology
Chemical
Reg. No./Substance:
51-43-4/Epinephrine

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


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