Vasopressin versus continuous adrenaline during experimental cardiopulmonary resuscitation

Resuscitation
Jakob JohanssonSten Rubertsson

Abstract

To evaluate the effects of a bolus dose of vasopressin compared to continuous adrenaline (epinephrine) infusion on vital organ blood flow during cardiopulmonary resuscitation (CPR). Ventricular fibrillation was induced in 24 anaesthetised pigs. After a 5-min non-intervention interval, CPR was started. After 2 min of CPR the animals were randomly assigned to receive either vasopressin (0.4 U/kg) or adrenaline (bolus of 20 microg/kg followed by continuous infusion of 10 microg/(kg min)). Defibrillation was attempted after 9 min of CPR. Vasopressin generated higher cortical cerebral blood flow (P < 0.001) and lower cerebral oxygen extraction (P < 0.001) during CPR compared to continuous adrenaline. Coronary perfusion pressure during CPR was higher in vasopressin-treated pigs (P < 0.001) and successful resuscitation was achieved in 12/12 in the vasopressin group versus 5/12 in the adrenaline group (P = 0.005). In this experimental model, vasopressin caused a greater increase in cortical cerebral blood flow and lower cerebral oxygen extraction during CPR compared to continuous adrenaline. Furthermore, vasopressin generated higher coronary perfusion pressure and increased the likelihood of restoring spontaneous circulation.

References

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Citations

Apr 18, 2014·Current Opinion in Critical Care·Kjetil Sunde, Theresa M Olasveengen
Mar 22, 2012·Critical Care Clinics·Kjetil Sunde, Petter Andreas Steen
Oct 28, 2009·The American Journal of Emergency Medicine·Meng-Hua ChenXiao-Fen Tian
Oct 18, 2008·The American Journal of Emergency Medicine·Yong WangLingxin Meng
May 25, 2007·Pharmacology & Therapeutics·Peter E PensonKenneth J Broadley
May 24, 2006·Pharmacotherapy·Todd A Miano, Michael A Crouch
Jul 20, 2007·The Journal of Clinical Endocrinology and Metabolism·Gabor SzinnaiMirjam Christ-Crain
Aug 26, 2006·Anesthesiology·Tanja A Treschan, Jürgen Peters

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