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  • Epinephrine increases the severity of postresuscitation myocardial dysfunction
    Tang, Wanchun ...
    BACKGROUND: Epinephrine has been the mainstay for cardiac resuscitation for more than 30 years. Its vasopressor effect by which it inusion pressure is likely to favor initial resuscitation. Its ... beta-adrenergic action, however, may have detrimental effects on postresuscitation myocardial function when administered before resuscitation because it increases myocardial oxygen consumption. In the present study, our focus was on postresuscitation effects of epinephrine when this adrenergic agent was administered during cardiopulmonary resuscitation. Postresuscitation myocardial functions were compared with those of a selective alpha-adrenergic agent, phenylephrine, whenepinephrine was combined with a beta 1-adrenergic blocking agent, esmolol,and saline placebo. METHODS AND RESULTS: Ventricular fibrillation was induced in 40 Sprague-Dawley rats. Mechanical ventilation and precordial compression was initiated either 4 or 8 minutes after the start of ventricularfibrillation. The adrenergic drug or saline placebo was administered as a bolus after 4 minutes of precordial compression. Defibrillation was attempted 4 minutes later. Left ventricular pressure, dP/dt40, and negative dP/dt were continuously measured for an interval of 240 minutes after successful cardiac resuscitation. Except for saline placebo, comparable increases in coronary perfusion pressure were observed after each drug intervention. The number of countershocks required for restoration of spontaneous circulation was significantly greater for epinephrine-treated animals (10 +/- 8) when compared with phenylephrine-treated animals (1.8 +/- 0.4, P less th. .01) and with animals treated with epinephrine combined with esmolol (1.6 +/- 0.9, P less th. .01). After resuscitation, dP/dt40 and negative dP/dt were significantly decreased and left ventricular end-diastolicpressure was significantly increased in each animal when comparedwith prearrest levels.(trunc.)
    Vir: Circulation. - ISSN 0009-7322 (Let. 92, št. 10, 1995, str. 3089-3093)
    Vrsta gradiva - članek, sestavni del
    Leto - 1995
    Jezik - angleški
    COBISS.SI-ID - 7151321

vir: Circulation. - ISSN 0009-7322 (Let. 92, št. 10, 1995, str. 3089-3093)
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