Document Detail


The effect of standard- and high-dose epinephrine on coronary perfusion pressure during prolonged cardiopulmonary resuscitation.
MedLine Citation:
PMID:  1996000     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied the effect of standard and high doses of epinephrine on coronary perfusion pressure during cardiopulmonary resuscitation in 32 patients whose cardiac arrest was refractory to advanced cardiac life support. Simultaneous aortic and right atrial pressures were measured and plasma epinephrine levels were sampled. Patients remaining in cardiac arrest after multiple 1-mg doses of epinephrine received a high dose of 0.2 mg/kg. The increase in the coronary perfusion pressures was 3.7 +/- 5.0 mm Hg following a standard dose, not a statistically significant change. The increase after a high dose was 11.3 +/- 10.0 mm Hg; this was both statistically different than before administration and larger than after a standard dose. High-dose epinephrine was more likely to raise the coronary perfusion pressure above the previously demonstrated critical value of 15 mm Hg. The highest arterial plasma epinephrine level after a standard dose was 152 +/- 162 ng/mL, and after a high dose, 393 +/- 289 ng/mL. Because coronary perfusion pressure is a good predictor of outcome in cardiac arrest, the increase after high-dose epinephrine may improve rates of return of spontaneous circulation.
Authors:
N A Paradis; G B Martin; J Rosenberg; E P Rivers; M G Goetting; T J Appleton; M Feingold; P E Cryer; J Wortsman; R M Nowak
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA     Volume:  265     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1991 Mar 
Date Detail:
Created Date:  1991-03-27     Completed Date:  1991-03-27     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1139-44     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aorta / physiopathology*
Blood Gas Analysis
Blood Pressure
Coronary Circulation
Epinephrine / administration & dosage*,  blood
Heart Atria / physiopathology*
Humans
Middle Aged
Perfusion
Prospective Studies
Resuscitation*
Chemical
Reg. No./Substance:
YKH834O4BH/Epinephrine
Comments/Corrections
Comment In:
JAMA. 1991 Aug 7;266(5):656-7   [PMID:  2072475 ]
JAMA. 1991 Mar 6;265(9):1160-1   [PMID:  1996003 ]

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


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