Combination pharmacotherapy improves neurological outcome after asphyxial cardiac arrest (Journal article)

Varvarousi, G./ Johnson, E. O./ Goulas, S./ Agrogiannis, G./ Valsamakis, N./ Perrea, D./ Stefanadis, C./ Papadimitriou, L./ Xanthos, T.


AIM: To study the effects of the combination of adrenaline (epinephrine) and vasopressin compared to adrenaline alone on initial resuscitation success, 24h survival, and neurological outcome in a swine model of asphyxial cardiac arrest (CA). METHODS: This prospective randomized experimental study was conducted at a laboratory research department. Twenty female Landrace/Large-White pigs, 12-15weeks of age, were investigated. Asphyxial CA was induced by clamping of the endotracheal tube. After 4min of untreated CA, resuscitation was initiated by unclamping the endotracheal tube, mechanical ventilation, chest compressions and adrenaline (Group A) or a combination of adrenaline with vasopressin (Group A+V) administered intravenously. In case of restoration of spontaneous circulation (ROSC), the animals were monitored for 30min and then observed for 24h. RESULTS: Hemodynamic variables were measured at baseline during CPR and in the post-resuscitation period. Statistically significant difference was observed in groups A and A+V regarding coronary perfusion pressure (CPP) during the first minute of CPR. In both groups, ROSC and survival rates were comparable (p=NS). Neurological deficit score (NDS) was significantly higher in the combination group 24h following CA (p<0.001). Brain histological damage score (HDS) was also better in the combination group (p<0.001). Total HDS and NDS showed a statistical significant correlation (p<0.001). CONCLUSIONS: In this porcine model of asphyxial CA, adrenaline alone as well as the combined administration of adrenaline and vasopressin resulted in similar ROSC and survival rates, but the combination of adrenaline and vasopressin resulted in improved neurological and cerebral histopathological outcomes.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/22980
ISSN: 1873-1570
Item type: journalArticle
Link: http://www.ncbi.nlm.nih.gov/pubmed/21963816
http://ac.els-cdn.com/S0300957211005612/1-s2.0-S0300957211005612-main.pdf?_tid=2db513fab172b8ef7988a979963ab748&acdnat=1334047951_524d405ba2b5a731e85285a6f858eba5
Item language: en
Item access scheme: campus
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Publication date: 2012
Abstract: AIM: To study the effects of the combination of adrenaline (epinephrine) and vasopressin compared to adrenaline alone on initial resuscitation success, 24h survival, and neurological outcome in a swine model of asphyxial cardiac arrest (CA). METHODS: This prospective randomized experimental study was conducted at a laboratory research department. Twenty female Landrace/Large-White pigs, 12-15weeks of age, were investigated. Asphyxial CA was induced by clamping of the endotracheal tube. After 4min of untreated CA, resuscitation was initiated by unclamping the endotracheal tube, mechanical ventilation, chest compressions and adrenaline (Group A) or a combination of adrenaline with vasopressin (Group A+V) administered intravenously. In case of restoration of spontaneous circulation (ROSC), the animals were monitored for 30min and then observed for 24h. RESULTS: Hemodynamic variables were measured at baseline during CPR and in the post-resuscitation period. Statistically significant difference was observed in groups A and A+V regarding coronary perfusion pressure (CPP) during the first minute of CPR. In both groups, ROSC and survival rates were comparable (p=NS). Neurological deficit score (NDS) was significantly higher in the combination group 24h following CA (p<0.001). Brain histological damage score (HDS) was also better in the combination group (p<0.001). Total HDS and NDS showed a statistical significant correlation (p<0.001). CONCLUSIONS: In this porcine model of asphyxial CA, adrenaline alone as well as the combined administration of adrenaline and vasopressin resulted in similar ROSC and survival rates, but the combination of adrenaline and vasopressin resulted in improved neurological and cerebral histopathological outcomes.
Journal name: Resuscitation
Journal type: peer-reviewed
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

Files in This Item:
File Description SizeFormat 
Varvarousi-2012-Combination pharmaco.pdf600.89 kBAdobe PDFView/Open    Request a copy



 Please use this identifier to cite or link to this item:
http://olympias.lib.uoi.gr/jspui/handle/123456789/22980
  This item is a favorite for 0 people.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.