| A comparison of vasopressin and glucagon in beta-blocker induced toxicity. | |
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MedLine Citation:
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PMID: 16496493 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We compared the efficacy of vasopressin and glucagon in a porcine model of beta-blocker toxicity. Our primary outcome was survival over 4 hours. METHODS: Sixteen pigs received a 1-mg/ kg bolus of propranolol IV followed by continuous infusion at 0.25 mg/kg/minute. Toxicity was defined as a 25% decrease in the product of heart rate (HR) and mean arterial pressure (MAP), at which point 20 mL/kg normal saline was rapidly infused. Each pig was randomly assigned to receive either vasopressin or glucagon after the saline bolus. The vasopressin group received a continuous infusion at 0.0028 U/kg/minute, titrated up to a maximum of 0.014 U/ kg/minute. The glucagon group received a 0.05-mg/kg bolus followed by continuous infusion at 0.15 mg/kg/hour. The HR, MAP, systolic BP (SBP), cardiac output (CO), glucose, and pH were monitored for 4 hours from toxicity or until death. RESULTS: One pig survived at 4 hours (vasopressin group). Analysis of the 4-hour Kaplan-Meier survival curves found no differences between the groups (log-rank test 0.059, p = 0.81). No overall differences were identified in MAP, systolic BP, cardiac output, glucose, pH, or HR. However, over the first hour MAP and SBP were significantly higher in the vasopressin group (p = 0.004, p = 0.006, respectively). CONCLUSION: In this beta-blocker toxicity model, there were no differences in the survival curves between vasopressin- and glucagon-treated pigs during a 4-hour analysis period. No overall differences were noted in MAP, systolic BP, CO, HR, pH, or glucose levels, although vasopressin treatment yielded higher MAP and systolic BP early in resuscitation. |
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Authors:
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Joel S Holger; Kristin M Engebretsen; Christopher L Obetz; Tanya L Kleven; Carson R Harris |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Clinical toxicology (Philadelphia, Pa.) Volume: 44 ISSN: 1556-3650 ISO Abbreviation: Clin Toxicol (Phila) Publication Date: 2006 |
Date Detail:
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Created Date: 2006-02-24 Completed Date: 2006-03-14 Revised Date: 2009-11-17 |
Medline Journal Info:
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Nlm Unique ID: 101241654 Medline TA: Clin Toxicol (Phila) Country: United States |
Other Details:
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Languages: eng Pagination: 45-51 Citation Subset: AIM; IM |
Affiliation:
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Department of Emergency Medicine, Regions Hospital, St. Paul, Minnesota 55101, USA. Joel.S.Holger@HealthPartners.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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poisoning* Animals Blood Pressure / drug effects Disease Models, Animal Glucagon / therapeutic use* Heart Rate / drug effects Hemodynamics / drug effects Poisoning / drug therapy, mortality, physiopathology Propranolol / poisoning* Survival Rate Swine Vasoconstrictor Agents / therapeutic use* Vasopressins / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Vasoconstrictor Agents; 11000-17-2/Vasopressins; 525-66-6/Propranolol; 9007-92-5/Glucagon |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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