Nitroglycerin and epinephrine improve coronary perfusion pressure in a porcine model of ventricular fibrillation arrest: a pilot study.
Title | Nitroglycerin and epinephrine improve coronary perfusion pressure in a porcine model of ventricular fibrillation arrest: a pilot study. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Kitsou, V., Xanthos T., Stroumpoulis K., Rokas G., Papadimitriou D., Serpetinis I., Dontas I., Perrea D., & Kouskouni E. |
Journal | J Emerg Med |
Volume | 37 |
Issue | 4 |
Pagination | 369-75 |
Date Published | 2009 Nov |
ISSN | 0736-4679 |
Keywords | Animals, Cardiopulmonary Resuscitation, Drug Therapy, Combination, Epinephrine, Female, Heart Arrest, Injections, Intravenous, Male, Myocardial Reperfusion, Nitroglycerin, Sus scrofa, Sympathomimetics, Vasodilator Agents, Ventricular Fibrillation |
Abstract | BACKGROUND: Cardiac arrest remains one of the leading causes of death worldwide. European Resuscitation Council Guidelines for Resuscitation 2005 recommend epinephrine for its treatment.OBJECTIVES: To estimate whether the administration of a vasodilatator such as nitroglycerin in combination with epinephrine during cardiopulmonary resuscitation would improve resuscitation outcome in an established model of ventricular fibrillation.METHODS: DESIGN: Prospective, randomized, blinded, controlled study.SETTING: Animal research laboratory. Ventricular fibrillation was induced in 20 Landrace/Large-White pigs. It remained untreated for 8 min before attempting resuscitation precordial compressions, mechanical ventilation, and electrical defibrillation. Animals were randomized into two groups, 10 animals each. Group A received saline as placebo (10 mL dilution, bolus) and epinephrine (0.02 mg/kg). Group B received nitroglycerin (50 microg/kg) and epinephrine (0.02 mg/kg) during cardiopulmonary resuscitation. Electrical defibrillation was attempted after 10 min of ventricular fibrillation.RESULTS: Four animals in group A restored spontaneous circulation in comparison to eight in Group B. Coronary perfusion pressure (p < 0.0001) was significantly increased in Group B during cardiopulmonary resuscitation.CONCLUSION: A vasodilatator, when administered in combination with a vasopressor such as epinephrine during cardiopulmonary resuscitation, increases coronary perfusion pressure. |
DOI | 10.1016/j.jemermed.2008.07.003 |
Alternate Journal | J Emerg Med |
PubMed ID | 19097731 |