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Vasopressin instead of epinephrine enhances efficacy of CPR without causing tachycardia (1150.5)
Author(s) -
Cherry Brandon,
Nguyen Anh,
Williams Arthur,
Scott Gary,
Hollrah Roger,
Ryou MyoungGwi,
Hoxha Besim,
OlivenciaYurvati Albert,
Mallet Robert
Publication year - 2014
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.28.1_supplement.1150.5
Subject(s) - medicine , vasopressin , defibrillation , cardiopulmonary resuscitation , tachycardia , epinephrine , cardiology , cardioversion , anesthesia , ventricular fibrillation , resuscitation , blood pressure , atrial fibrillation
Survival from cardiac arrest is highly dependent on the arterial pressure generated by cardiopulmonary resuscitation (CPR). To increase efficacy of precordial compressions, the potent vasoconstrictor epinephrine (EPI) is administered. However, EPI also elicits a robust, β 1 ‐adrenoceptor‐mediated tachycardia following defibrillation, depleting the myocardium of the energy reserves it requires for recovery. We proposed that the adrenoceptor‐independent vasoconstrictor vasopressin (AVP) increases arterial pressure as effectively as EPI without producing tachycardia. After 6 min pacing‐induced cardiac arrest, domestic swine (25‐35 kg; 10 boars, 11 sows) received precordial compressions (100/min) for 4 min, and either EPI (0.1 mg; n =5) or AVP (10 U; n =16) was injected iv at 1 min CPR. EPI and AVP similarly increased mean arterial pressure from 31±3 to 66±4 mmHg vs . 34±3 to 59±3 mmHg at 4 min CPR. Countershock energy to achieve cardioversion was 16±4 J/kg in EPI‐ vs . 12±2 J/kg in AVP‐treated pigs. Post‐arrest tachycardia was less intense in AVP‐ (133±11 bpm) than EPI‐treated (174±14 bpm) pigs ( P <0.05). Thus, AVP augments CPR as effectively as EPI but avoids tachycardia. Support: NINDS R01NS076975, NIA T32AG020494 Grant Funding Source : Supported by: NINDS R01NS076975, NIA T32AG020494