Epinephrine, but not vasopressin, improves survival rates in an adult rabbit model of asphyxia cardiac arrest
Epinephrine, but not vasopressin, improves survival rates in an adult rabbit model of asphyxia cardiac arrest
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DOI：
10.1016/j.ajem.2006.08.022
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发表时间：
2007-06-01
影响因子：
3.6
通讯作者：
Mo, Shu-Rong
中科院分区：
文献类型：
--
作者：
Chen, Meng-Hua;Xie, Lu;Mo, Shu-Rong
虽然加压素在室颤动物模型的心肺复苏中比肾上腺素更有效，但其在窒息模型中的有效性仍存在争议。本研究旨在探讨加压素和肾上腺素对窒息性心脏骤停家兔自主循环恢复（ROSC）的作用。通过夹闭气管导管诱导心脏骤停。在5分钟的基本生命支持心脏复苏后，没有ROSC的动物被随机分配接受单独的肾上腺素（肾上腺素组; 200 μ g/kg）或单独的加压素（加压素组; 0.8 U/kg）。冠状动脉灌注压（CPP）计算为最小舒张期主动脉压和同时记录的右心房压之间的差值。自主循环恢复定义为动脉收缩压≥ 60 mm Hg的无辅助脉搏持续5分钟或更长时间。我们在62只家兔中诱导停搏，其中15只在给药前有ROSC，并从分析中排除。其余47只家兔随机分为肾上腺素组（n = 24）和加压素组（n = 23）。给药前后，肾上腺素组CPP显著增加（峰值从-4 +/-4到36 +/-9 mmHg，P =.000），而加压素组CPP仅轻微增加（峰值从9.5到18.6 mmHg，P =.20）。给药后，24只肾上腺素兔中有13只出现ROSC，23只加压素兔中仅有2只出现ROSC（P
Although vasopressin has been reported lobe more effective than epinephrine for cardiopulmonary resuscitation in ventricular fibrillation animal models, its efficacy in asphyxia model remains controversy. The purpose of this study was to investigate the effectiveness of vasopressin vs epinephrine on restoration of spontaneous circulation (ROSC) in a rabbit model of asphyxia cardiac arrest. Cardiac arrest was induced by clamping endotracheal tube. After 5 minutes of basic life-support Cardiopulmonary resuscitation, animals who had no ROSC were randomly assigned to receive either epinephrine alone (epinephrine group; 200 mu g/kg) or vasopressin alone (vasopressin group; 0.8 U/kg). The coronary perfusion pressure (CPP) was calculated as the difference between the minimal diastolic aortic and simultaneously recorded right atrial pressure. Restoration of spontaneous circulation was defined as an unassisted pulse with a systolic arterial pressure of 60 mm Hg or higher for 5 minutes or longer. We induced arrest in 62 rabbits, 15 of whom had ROSC before drug administration and were excluded from analysis. The remaining 47 rabbits were randomized to epinephrine group (n = 24) and vasopressin group (n = 23). Before and after drug administration, CPP in epinephrine group increased significantly (from -4 +/- 4 to 36 +/- 9 mm Hg at peak value, P =.000), whereas CPP in vasopressin group increased only slightly (from 9 5 to 18 6 mm Hg at peak value, P =.20). After drug administration, 13 of 24 epinephrine rabbit had ROSC, and only 2 of 23 vasopressin rabbit had ROSC (P