Vasopressin improves survival compared with epinephrine in a neonatal piglet model of asphyxial cardiac arrest.
Pediatr Res
; 75(6): 738-48, 2014 Jun.
Article
en En
| MEDLINE
| ID: mdl-24614799
ABSTRACT
BACKGROUND:
Epinephrine is a component of all resuscitation algorithms. Vasopressin is a pulmonary vasodilator and systemic vasopressor. We investigated the effect of epinephrine vs. vasopressin on survival and hemodynamics after neonatal porcine cardiac arrest (CA).METHODS:
A 4-min asphyxial CA was induced, after which cardiopulmonary resuscitation (CPR) was commenced. Animals were randomized to low- (LDE 0.01 mg/kg) or high-dose epinephrine (HDE 0.03 mg/kg), low- (LDV 0.2 U/kg) or high-dose vasopressin (HDV 0.4 U/kg), or control (saline). Clinical and echocardiography indexes were monitored.RESULTS:
Sixty-nine animals were randomized. Survival was greater in HDV (n = 8 (89%); P < 0.05 ANOVA) vs. control (n = 7 (43%)) and LDE (n = 5 (36%)) but not vs. HDE (n = 7 (64%)) or LDV (n = 6 (75%)). Animals resuscitated with LDE required more shocks (2.5 (interquartile range 2-6); P < 0.05) and higher doses of energy (15 J (interquartile range 10-20); P < 0.05). Left ventricular output was comparable between groups, but a greater increase in superior vena caval flow was seen after HDV (P < 0.001 vs. control, LDE, and HDE). Plasma troponin was greatest in the HDE group (P < 0.05 vs. control and HDV).CONCLUSION:
Vasopressin results in improved survival, lower postresuscitation troponin, and less hemodynamic compromise after CA in newborn piglets. Vasopressin may be a candidate for testing in human neonates.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Vasopresinas
/
Epinefrina
/
Reanimación Cardiopulmonar
/
Paro Cardíaco
Límite:
Animals
Idioma:
En
Revista:
Pediatr Res
Año:
2014
Tipo del documento:
Article
País de afiliación:
Canadá