Use of bretylium tosylate as prophylaxis and treatment in hypothermic ventricular fibrillation in the canine model

Annals of Emergency Medicine
K MurphyM C Tomlanovich

Abstract

We conducted a study to determine if bretylium tosylate (BT) is effective in the prophylaxis and treatment of hypothermic ventricular fibrillation (VF) in the setting of various maneuvers thought to induce this lethal arrhythmia. Twenty-two mongrel dogs were cooled to 24 C after being placed in a cold room. At 24 C, a double-blinded placebo or BT solution was infused. The dogs then were removed from the cold. They underwent the following sequential maneuvers: oral endotracheal extubation and intubation, central line and nasogastric tube placement, vigorous movement, and Swan-Ganz catheter insertion. If VF ensued, arterial blood gases were drawn, and BT was given only if refractory to countershock and epinephrine. Of the dogs that were given placebo, six of 11 (55%) fibrillated with manipulation, as compared with one of 11 (9%) dogs pretreated with BT (P = .067). Three of the 11 dogs that received BT fibrillated within minutes of its infusion. In the placebo dogs that fibrillated, four required BT and two defibrillated with countershock alone or with epinephrine prior to achieving stable rhythms.

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Citations

Jul 1, 1992·The American Journal of Emergency Medicine·A OrtsM M Puig
Jul 1, 1994·The American Journal of Emergency Medicine·H BjørnstadH Refsum
Dec 5, 2006·Annals of Emergency Medicine·Jeffrey D HoDouglas D Brunette
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Feb 26, 2019·High Altitude Medicine & Biology·Peter MairBeat Walpoth
May 1, 1992·The Journal of Pediatrics·H M Corneli
May 20, 1999·Critical Care Clinics·N A Hanania, J L Zimmerman

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