Dose-dependent vasopressor response to epinephrine during CPR in human beings

Annals of Emergency Medicine
E GonzalezE M Racht

Abstract

The optimal dose of epinephrine during CPR in human beings is unknown. We studied ten prehospital cardiac arrest patients (six men and four women; mean age, 54 +/- 5 years) to determine the vasopressor response and change in the end-tidal carbon dioxide concentration (PetCO2) after incremental (1-, 3-, and 5-mg) doses of IV epinephrine given five minutes apart during closed-chest CPR. All patients were in ventricular fibrillation on arrival of the paramedics and did not respond to standard advanced cardiac life support. CPR was performed with a computerized Thumper; all patients were intubated and ventilated at 12 times a minute at an FiO2 of 0.8. Radial artery pressure was measured with a 20 angiocath inserted by radial artery cutdown. Paramedic response time was 4.3 +/- 0.5 minutes; elapsed time to emergency department arrival was 40.0 +/- 9.5 minutes. Initial blood gases were paO2, 241 +/- 50 mm Hg; pH, 7.23 +/- 0.08; paCO2, 27 +/- 5 mm Hg; and HCO3, 11 +/- 2 mEq/L. Baseline systolic and diastolic blood pressures were 47 +/- 5 mm Hg and 18 +/- 2 mm Hg, respectively. Systolic blood pressure was directly related to the dose of epinephrine (P less than .0001), rising to 69 +/- 7 mm Hg, 74 +/- 8 mm Hg, and 85 +/- 8 mm Hg after 1...Continue Reading

References

Sep 1, 1988·Cleveland Clinic Journal of Medicine·M G BazaralF G Estafanous
Mar 1, 1986·Archives of Emergency Medicine·R A LittleG S Laing
Oct 1, 1985·Annals of Emergency Medicine·A B SandersK B Kern
Nov 1, 1985·Critical Care Medicine·M H WeilE C Rackow
Nov 1, 1985·Critical Care Medicine·R P TrevinoW G Grundler
Jul 1, 1968·The British Journal of Surgery·R L Rothwell-Jackson
Nov 1, 1965·Anesthesia and Analgesia·J W Pearson, J S Redding
Sep 1, 1984·Annals of Emergency Medicine·S H Ralston
Nov 1, 1981·Naunyn-Schmiedeberg's Archives of Pharmacology·M C Camilión de HurtadoH E Cingolani
Sep 1, 1984·Annals of Emergency Medicine·R E JacksonT J Hoehner
Jul 20, 1983·The American Journal of Cardiology·K A ReimerA H Tatum
Mar 1, 1963·Anesthesiology·J S REDDING, J W PEARSON

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Citations

Apr 1, 1996·Resuscitation·N A Paradis
Jan 1, 1997·Immunology Letters·M AnticaR Scollay
May 8, 1998·Resuscitation·J VaronR E Fromm
Oct 8, 1992·The New England Journal of Medicine·I G StiellG E Dickinson
Apr 23, 2004·The New England Journal of Medicine·Maria Beatriz M PerondiRobert A Berg
Feb 1, 1996·Journal of Paediatrics and Child Health·I HigginsonR Tuck
Jul 1, 1996·Journal of Accident & Emergency Medicine·T H Rainer, C E Robertson
Mar 20, 2012·Resuscitation·Todd M LarabeeCharles M Little
Mar 22, 2012·Critical Care Clinics·Kjetil Sunde, Petter Andreas Steen
May 25, 2007·Pharmacology & Therapeutics·Peter E PensonKenneth J Broadley
Oct 20, 2015·Resuscitation·Ian K MaconochieUNKNOWN Paediatric life support section Collaborators
May 24, 2006·Pharmacotherapy·Todd A Miano, Michael A Crouch
Nov 1, 1991·The Journal of Emergency Medicine·P HebertR M Stark
Aug 1, 1992·Journal of Cardiothoracic and Vascular Anesthesia·M H Weil, M Noc
Jan 1, 1991·Annals of Emergency Medicine·M G Goetting, N A Paradis
Nov 1, 1990·Annals of Emergency Medicine·N A Paradis, E M Koscove
Aug 25, 2001·Seminars in Neonatology : SN·M H WyckoffS Niermeyer
Oct 11, 2014·Resuscitation·Sam ParniaElinor R Schoenfeld
Jan 1, 1994·Annals of Emergency Medicine·R D White, B R Asplin
Oct 1, 1990·Chest·H R Halperin, A D Guerci
Mar 15, 2006·Clinics in Perinatology·Myra H Wyckoff, Jeffrey M Perlman
Feb 1, 1993·Annals of Emergency Medicine·J P Ornato

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