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Neural injury after use of vasopressin and adrenaline during porcine cardiopulmonary resuscitation.

Halvorsen P, Sharma HS, Basu S, Wiklund L - Ups. J. Med. Sci. (2015)

Bottom Line: After restoration of spontaneous circulation there was no difference in the pressure variables, but CCBF tended to be (36% ± 16%) higher in the V group.Neuronal injury and signs of a disrupted blood-brain barrier (BBB) were greater, 20% ± 4% and 21% ± 4%, respectively, in the VA group.In a background study of repeated single doses of adrenaline every third minute after 5 min arrest but otherwise the same protocol, histological measurements showed even worse neural injury and disruption of the BBB.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Sciences/Anesthesiology and Intensive Care Medicine, Uppsala University , SE-751 85 Uppsala , Sweden.

ABSTRACT

Background: Our aim was to investigate cerebral and cardiac tissue injury subsequent to use of vasopressin and adrenaline in combination compared with vasopressin alone during cardiopulmonary resuscitation (CPR).

Methods: In a randomized, prospective, laboratory animal study 28 anesthetized piglets were subject to a 12-min untreated cardiac arrest and subsequent CPR. After 1 min of CPR, 10 of the piglets received 0.4 U/kg of arg(8)-vasopressin (V group), and 10 piglets received 0.4 U/kg of arg(8)-vasopressin, 1 min later followed by 20 µg/kg body weight of adrenaline, and another 1 min later continuous administration (10 µg/kg/min) of adrenaline (VA group). After 8 min of CPR, the piglets were defibrillated and monitored for another 3 h. Then they were killed and the brain immediately removed pending histological analysis.

Results: During CPR, the VA group had higher mean blood pressure and cerebral cortical blood flow (CCBF) but similar coronary perfusion pressure. After restoration of spontaneous circulation there was no difference in the pressure variables, but CCBF tended to be (36% ± 16%) higher in the V group. Neuronal injury and signs of a disrupted blood-brain barrier (BBB) were greater, 20% ± 4% and 21% ± 4%, respectively, in the VA group. In a background study of repeated single doses of adrenaline every third minute after 5 min arrest but otherwise the same protocol, histological measurements showed even worse neural injury and disruption of the BBB.

Conclusion: Combined use of vasopressin and adrenaline caused greater signs of cerebral and cardiac injury than use of vasopressin alone during experimental cardiopulmonary resuscitation.

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Related in: MedlinePlus

Systemic circulatory variables in the background study for surviving and non-surviving animals. Surviving animals ▴; non-surviving animals ▾.
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Figure 3: Systemic circulatory variables in the background study for surviving and non-surviving animals. Surviving animals ▴; non-surviving animals ▾.

Mentions: During CPR, surviving animals had somewhat higher CPP (P = 0.02), but similar MBP (P = 0.8) and CCBF (P = 0.9) compared with the animals not achieving ROSC (Figure 3).


Neural injury after use of vasopressin and adrenaline during porcine cardiopulmonary resuscitation.

Halvorsen P, Sharma HS, Basu S, Wiklund L - Ups. J. Med. Sci. (2015)

Systemic circulatory variables in the background study for surviving and non-surviving animals. Surviving animals ▴; non-surviving animals ▾.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4389003&req=5

Figure 3: Systemic circulatory variables in the background study for surviving and non-surviving animals. Surviving animals ▴; non-surviving animals ▾.
Mentions: During CPR, surviving animals had somewhat higher CPP (P = 0.02), but similar MBP (P = 0.8) and CCBF (P = 0.9) compared with the animals not achieving ROSC (Figure 3).

Bottom Line: After restoration of spontaneous circulation there was no difference in the pressure variables, but CCBF tended to be (36% ± 16%) higher in the V group.Neuronal injury and signs of a disrupted blood-brain barrier (BBB) were greater, 20% ± 4% and 21% ± 4%, respectively, in the VA group.In a background study of repeated single doses of adrenaline every third minute after 5 min arrest but otherwise the same protocol, histological measurements showed even worse neural injury and disruption of the BBB.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Sciences/Anesthesiology and Intensive Care Medicine, Uppsala University , SE-751 85 Uppsala , Sweden.

ABSTRACT

Background: Our aim was to investigate cerebral and cardiac tissue injury subsequent to use of vasopressin and adrenaline in combination compared with vasopressin alone during cardiopulmonary resuscitation (CPR).

Methods: In a randomized, prospective, laboratory animal study 28 anesthetized piglets were subject to a 12-min untreated cardiac arrest and subsequent CPR. After 1 min of CPR, 10 of the piglets received 0.4 U/kg of arg(8)-vasopressin (V group), and 10 piglets received 0.4 U/kg of arg(8)-vasopressin, 1 min later followed by 20 µg/kg body weight of adrenaline, and another 1 min later continuous administration (10 µg/kg/min) of adrenaline (VA group). After 8 min of CPR, the piglets were defibrillated and monitored for another 3 h. Then they were killed and the brain immediately removed pending histological analysis.

Results: During CPR, the VA group had higher mean blood pressure and cerebral cortical blood flow (CCBF) but similar coronary perfusion pressure. After restoration of spontaneous circulation there was no difference in the pressure variables, but CCBF tended to be (36% ± 16%) higher in the V group. Neuronal injury and signs of a disrupted blood-brain barrier (BBB) were greater, 20% ± 4% and 21% ± 4%, respectively, in the VA group. In a background study of repeated single doses of adrenaline every third minute after 5 min arrest but otherwise the same protocol, histological measurements showed even worse neural injury and disruption of the BBB.

Conclusion: Combined use of vasopressin and adrenaline caused greater signs of cerebral and cardiac injury than use of vasopressin alone during experimental cardiopulmonary resuscitation.

Show MeSH
Related in: MedlinePlus