Journal
RESUSCITATION
Volume 101, Issue -, Pages 77-83Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.resuscitation.2016.01.032
Keywords
Cardiac arrest; CPR; Adrenaline
Categories
Funding
- Swedish Heart and Lung Foundation
- Thelma Zoega's Foundation
- Laerdal Foundation
- Skane County Council's Office of Research and Development Foundation
- Swedish Research Council
- Marianne and Marcus Wallenberg's Foundation
- Swedish Medical Society
- SUMMIT (part of the Innovative Medicines Initiative within the European Commission's Seventh Framework Programme)
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Background: This porcine study was designed to explore the effects of repetitive intravenous adrenaline doses on physiologic parameters during CPR. Methods: Thirty-six adult pigs were randomised to four injections of: adrenaline 0.02 mg (kg dose)(-1), adrenaline 0.03 mg (kg dose)(-1) or saline control. The effect on systolic, diastolic and mean arterial blood pressure, cerebral perfusion pressure (CePP), end tidal carbon dioxide (ETCO2), arterial oxygen saturation via pulse oximetry (SpO(2)), cerebral tissue oximetry (SctO(2)), were analysed immediately prior to each injection and at peak arterial systolic pressure and arterial blood gases were analysed at baseline and after 15 min. Result: In the group given 0.02 mg (kg dose)(-1), there were increases in all arterial blood pressures at all 4 pressure peaks but CePP only increased significantly after peak 1. A decrease in ETCO2 following peak 1 and 2 was observed. SctO(2) and SpO(2) were lowered following injection 2 and beyond. In the group given a 0.03 mg (kg dose)(-1), all ABP's increased at the first 4 pressure peaks but CePP only following 3 pressure peaks. Lower ETCO2, SctO(2) and SpO(2) were seen at peak 1 and beyond. In the two adrenaline groups, pH and Base Excess were lower and lactate levels higher compared to baseline as well as compared to the control. Conclusion: Repetitive intravenous adrenaline doses increased ABP's and to some extent also CePP, but significantly decreased organ and brain perfusion. The institutional protocol number: Malmo/Lund Committee for Animal Experiment Ethics, approval reference number: M 192-10. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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