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Levosimendan improves the initial outcome of cardiopulmonary resuscitation in a swine model of cardiac arrest
Author(s) -
Koudouna E.,
Xanthos T.,
Bassiakou E.,
Goulas S.,
Lelovas P.,
Papadimitriou D.,
Tsirikos N.,
Papadimitriou L.
Publication year - 2007
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2007.01383.x
Subject(s) - medicine , coronary perfusion pressure , cardiopulmonary resuscitation , ventricular fibrillation , epinephrine , resuscitation , defibrillation , anesthesia , bolus (digestion) , levosimendan , return of spontaneous circulation , perfusion , cardiology , heart failure
Background: Cardiac arrest remains the leading cause of death in Western societies. Advanced Life Support guidelines propose epinephrine (adrenaline) for its treatment. The aim of this study was to assess whether a calcium sensitizer agent, such as levosimendan, administered in combination with epinephrine during cardiopulmonary resuscitation, would improve the initial resuscitation success. Methods: Ventricular fibrillation was induced in 20 Landrace/Large‐White piglets, and left untreated for 8 min. Resuscitation was then attempted with precordial compressions, mechanical ventilation and electrical defibrillation. The animals were randomized into two groups (10 animals each): animals in Group A received saline as placebo (10 ml dilution, bolus) + epinephrine (0.02 mg/kg), and animals in Group B received levosimendan (0.012 mg/kg/10 ml dilution, bolus) + epinephrine (0.02 mg/kg) during cardiopulmonary resuscitation. Electrical defibrillation was attempted after 10 min of ventricular fibrillation. Results: Four animals in Group A showed restoration of spontaneous circulation and 10 in Group B ( P = 0.011). The coronary perfusion pressure, saturation of peripheral oxygenation and brain regional oxygen saturation were significantly higher during cardiopulmonary resuscitation in Group B. Conclusions: A calcium sensitizer agent, when administered during cardiopulmonary resuscitation, significantly improves initial resuscitation success and increases coronary perfusion pressure during cardiopulmonary resuscitation.