The pharmacological effect of epinephrine administration via laryngeal mask airway in a porcine model of asphyxial cardiac arrest.

ABSTRACT

BACKGROUND: Earlier studies have shown that the laryngeal mask airway (LMA) is an effective alternative method for the administration of drugs. The pharmacological effect of drug administration via the LMA in cardiac arrest is still unknown. This study was designed to compare the effect of epinephrine administration tracheally or through the LMA in an asphyxial resuscitated porcine model. METHODS: Asphyxial cardiac arrest was initiated in 24 pigs, which remained untreated for 2 minutes. After 1 minute of basic life support cardiopulmonary resuscitation, the pigs were assigned to receive epinephrine (50 microg/kg) administration via one of three routes, either tracheally (group ET), from the upper end of the LMA (group LMA), or from a catheter inserted through the LMA into the trachea (group LMAC). Plasma epinephrine (PE) levels were taken before asphyxia and every 2 minutes after cardiac arrest was introduced. RESULTS: All animals had significant elevation of PE levels after the administration of epinephrine. The peak PE level was highest for group LMAC and lowest for group LMA. There were no significant differences between groups LMAC and ET. CONCLUSION: Drug administration from a catheter through the LMA into the trachea achieved comparable PE levels to those achieved by the tracheal route. Epinephrine administered via the LMA catheter may be an acceptable alternative to treat asphyxial cardiac arrest.