| Use of cardiopulmonary bypass, high-dose epinephrine, and standard-dose epinephrine in resuscitation from post-countershock electromechanical dissociation. | |
| | |
MedLine Citation:
|
PMID: 1514715 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
STUDY OBJECTIVE: To determine the effects of cardiopulmonary bypass with standard-dose epinephrine, high-dose epinephrine, and standard-dose epinephrine on perfusion pressures, myocardial blood flow, and resuscitation from post-countershock electromechanical dissociation. DESIGN: Prospective, controlled laboratory investigation using a canine cardiac arrest model randomized to receive one of three resuscitation therapies. INTERVENTIONS: After the production of post-countershock electromechanical dissociation, 25 animals received ten minutes of basic CPR and were randomized to receive cardiopulmonary bypass with standard-dose epinephrine, high-dose epinephrine, or standard-dose epinephrine. MEASUREMENTS AND MAIN RESULTS: Myocardial blood flow was measured using a colored microsphere technique at baseline, during basic CPR, and after intervention. Immediate and two-hour resuscitation rates were determined for each group. Return of spontaneous circulation was achieved in eight of eight cardiopulmonary bypass with standard-dose epinephrine compared with four of eight high-dose epinephrine and three of eight standard-dose epinephrine animals (P less than .04). One animal was resuscitated with CPR alone and was excluded. Survival to two hours was achieved in five of eight cardiopulmonary bypass with standard-dose epinephrine, four of eight high-dose epinephrine, and three of eight standard-dose epinephrine animals (NS). Coronary perfusion pressure increased significantly in the cardiopulmonary bypass with standard-dose epinephrine group when compared with the other groups (cardiopulmonary bypass with standard-dose epinephrine, 76 +/- 45 mm Hg; high-dose epinephrine, 24 +/- 12 mm Hg; standard-dose epinephrine, 3 +/- 14 mm Hg; P less than .005). Myocardial blood flow was higher in cardiopulmonary bypass with standard-dose epinephrine and high-dose epinephrine animals compared with standard-dose epinephrine animals but did not reach statistical significance. Cardiac output increased during cardiopulmonary bypass with standard-dose epinephrine (P = .001) and standard-dose epinephrine (NS) compared with basic CPR but decreased after epinephrine administration in the high-dose epinephrine group (NS). CONCLUSION: Resuscitation from electromechanical dissociation was improved with cardiopulmonary bypass and epinephrine compared with high-dose epinephrine or standard-dose epinephrine alone. However, there was no difference in survival between groups. Cardiopulmonary bypass with standard-dose epinephrine resulted in higher cardiac output, coronary perfusion pressure, and a trend toward higher myocardial blood flow. A short period of cardiopulmonary bypass with epinephrine after prolonged post-countershock electromechanical dissociation cardiac arrest can re-establish sufficient circulation to effect successful early resuscitation. |
| | |
Authors:
|
D J DeBehnke; M G Angelos; J E Leasure |
Related Documents
:
|
7111375 - Inequality of clearance values obtained by intravenous bolus and by steady-state infusi... 3918475 - Use of a branched chain amino acid enriched solution in patients under metabolic stress. 11024395 - Safety and efficacy of an accelerated dobutamine stress echocardiography protocol in th... 16886975 - Levetiracetam intravenous infusion: a randomized, placebo-controlled safety and pharmac... 16832665 - Phase i and pharmacologic study of irinotecan and amrubicin in advanced non-small cell ... 19825285 - Use of a low-dose steroid as an adjunct in the treatment, in mice, of severe sepsis cau... |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Annals of emergency medicine Volume: 21 ISSN: 0196-0644 ISO Abbreviation: Ann Emerg Med Publication Date: 1992 Sep |
Date Detail:
|
Created Date: 1992-09-29 Completed Date: 1992-09-29 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8002646 Medline TA: Ann Emerg Med Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 1051-7 Citation Subset: AIM; IM |
Affiliation:
|
Department of Emergency Medicine, Wright State University, Dayton, Ohio. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Blood Pressure / drug effects, physiology Cardiac Output / drug effects, physiology Cardiopulmonary Bypass* Cardiopulmonary Resuscitation / methods* Combined Modality Therapy Coronary Circulation / drug effects, physiology Dogs Dose-Response Relationship, Drug Electric Countershock / adverse effects Epinephrine / administration & dosage*, therapeutic use Female Heart Arrest / etiology, physiopathology, therapy* Male Prospective Studies |
| Chemical | |
Reg. No./Substance:
|
51-43-4/Epinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Double-blind comparison of the clinical, hemodynamic, and electrocardiographic effects of sodium meg...
Next Document: Selective aortic arch perfusion during cardiac arrest: a new resuscitation technique.