Pulmonary gas exchange after cardiopulmonary resuscitation with either vasopressin or epinephrine

OBJECTIVEIt is well established that epinephrine administered during cardiopulmonary resuscitation results in pulmonary gas exchange disturbances. It is uncertain how vasopressin affects gas exchange after cardiopulmonary resuscitation. DESIGNProspective, randomized experimental study. SETTINGAnimal...

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Bibliographic Details
Published in:	Critical care medicine Vol. 30; no. 9; pp. 2059 - 2062
Main Authors:	Loeckinger, Alex, Kleinsasser, Axel, Wenzel, Volker, Mair, Victoria, Keller, Christian, Kolbitsch, Christian, Recheis, Wolfgang, Schuster, Antonius, Lindner, Karl H
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD by the Society of Critical Care Medicine and Lippincott Williams & Wilkins 01-09-2002 Lippincott
Subjects:	Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animals Biological and medical sciences Blood Gas Analysis Cardiopulmonary Resuscitation Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Epinephrine - pharmacology Hemodynamics - drug effects Intensive care medicine Medical sciences Pulmonary Gas Exchange - drug effects Swine Vasoconstrictor Agents - pharmacology Vasopressins - pharmacology Ventricular Fibrillation - therapy Animal model Agonist Peptide hormone Carbon dioxide α1-Adrenergic receptor Neuropeptide Randomization cardiopulmonary resuscitation blood pressures Neurohypophyseal hormone pulmonary gas exchange Epinephrine drug oxygen Ungulata Resuscitation ventricular fibrillation Cardiopulmonary epinephrine Catecholamine Experimental study Vasopressin Pig adrenergic agents Vertebrata Mammalia Animal partial pressures α-Adrenergic receptor agonist Artiodactyla Gas exchange Hemodynamics Comparative study
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Summary:	OBJECTIVEIt is well established that epinephrine administered during cardiopulmonary resuscitation results in pulmonary gas exchange disturbances. It is uncertain how vasopressin affects gas exchange after cardiopulmonary resuscitation. DESIGNProspective, randomized experimental study. SETTINGAnimal research laboratory. SUBJECTSTwenty domestic pigs. INTERVENTIONSAnimals were subjected to ventricular fibrillation and cardiopulmonary resuscitation by using either vasopressin or epinephrine. Hemodynamic and pulmonary gas exchange (multiple inert gas elimination technique) variables were recorded before cardiopulmonary resuscitation and 10, 30, 60, and 120 mins after return of spontaneous circulation when either epinephrine (control) or vasopressin was used. MEASUREMENTS AND MAIN RESULTSAt 10 mins after return of spontaneous circulation, blood flow to low VA/Q lung units was increased in animals treated with epinephrine (17.8 ± 6 vs. 2.6 ± 3%, mean ± sd, p < .01). Resulting carbon dioxide elimination was impaired in animals treated with epinephrine but not in animals treated with vasopressin (Paco2, 55 ± 2 vs. 46 ± 4 torr, p < .05). Thirty minutes after return of spontaneous circulation, blood flow to lung units with a normal VA/Q ratio was reduced in animals treated with epinephrine (79 ± 1 vs. 84 ± 12%, p < .05), resulting in a depressed Pao2 (147 ± 4 vs. 127 ± 10 torr, p < .05). CONCLUSIONVasopressin compared with epinephrine for cardiopulmonary resuscitation resulted in better gas exchange variables in the early postresuscitation phase.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0090-3493 1530-0293
DOI:	10.1097/00003246-200209000-00018