Myocardial oxygen delivery/consumption during cardiopulmonary resuscitation: A comparison of epinephrine and phenylephrine

Brown, Charles G.; Taylor, Ronald B.; Werman, Howard A.; Luu, Tuan; Ashton, James; Hamlin, Robert L.

doi:10.1016/s0196-0644(88)80767-4

Cited by 74 publications

(5 citation statements)

References 21 publications

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“…68,69 Studies also were performed to compare epinephrine 0.2 mglkg IV with phenylephrine 1 or 10 mglkg administered to swine as previously explained.w" Regional cerebral blood flow was increased in animals receiving epinephrine when compared with those receiving phenylephrine 1 mglkg; there was no difference in cerebral flow when animals receiving epinephrine were compared with those receiving phenylephrine 10 mglkg (p<0.05). 70 In a second study, animals receivingepinephrine demonstrated betterregional myocardial bloodflow than did thosereceiving phenylephrine. Additionally, 80 percent of the swine given epinephrine were resuscitated whereas none in the phenylephrine group survived,"Brillman et al demonstrated no difference in neurologic or cardiovascular outcomes in dogs that received either epinephrine 1 mg or phenylephrine 10 mg IV aftercardiacarrest,"…”

Section: Epinephrine (Adrenalin)mentioning

confidence: 95%

Controversies in Cardiopulmonary Resuscitation: Pediatric Considerations

Thompson

Raebel²,

Sagraves

et al. 1991

DICP

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This articleaddresses some therapeutic controversies concerning medications that may be neededduringadvancedpediatric life support(APLS) and the routesof administration that may be selected. The controversies that are discussedincludethe appropriateness and selection of variousroutesfor drug administration during APLS; the determination of whetherepinephrine hydrochloride is the adrenergic agentof choicefor APLS and its appropriate dose; treatment of acidosis associated with a cardiopulmonary arrest;recommendations for atropine sulfatedoses;and the role,if any, of calciumin APLS. Background information differentiating pediatricfrom adultcardiopulmonary arrestis presented to enablethe readerto have a betterunderstanding of the specific needsof childrenduring this life-threatening emergency. The articlealso presentsan overview of variousdrugs used for APLS and a table of their typically recommended doses and routes of administration. Pharmacother 1991;25:760-72. CHILDREN WHO EXPERIENCE CARDIAC ARREST typically have a poor prognosis.v' Pediatric survival rates from cardiac arrests that occur in the prehospital setting average 7 percent (3 percent if arrests were unwitnessed and 15 percent if witnessed by paramedics).' Such figures are low when compared with an overall survival rate of 20 percent for adults who experienced cardiac arrests in a similar setting," From DICPAnn

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Section: Epinephrine (Adrenalin)mentioning

confidence: 95%

Controversies in Cardiopulmonary Resuscitation: Pediatric Considerations

Thompson

Raebel²,

Sagraves

et al. 1991

DICP

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“…For example, adrenaline and noradrenaline both raise the aortic diastolic pressure by approximately 40 mmHg, whereas other a agonists will not. [28][29][30] The pure at agonists methoxamine and phenylephrine do not result in a consistent significant improvement in aortic diastolic pressure. 29 ,3O There are some differences in rapidity of response in ePR between adrenaline and noradrenaline, which are both at and a2 agonists, and the pure at agonists, which may result from the a2 difference.…”

Section: Adrenergic Stimulation During Cpr (I) Sympathetic Nervous Symentioning

confidence: 96%

Vasopressor Therapy in Cardiac Resuscitation

1992

Anaesth Intensive Care

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The standard 0.5 to 1.0 mg dose of adrenaline used in cardiac resuscitation may be inadequate on the basis of theoretical and experimental evidence. Well designed clinical trials are indicated to test the hypothesis that higher doses of adrenaline could be more effective in specific subgroups of people experiencing cardiac arrest. The success in resuscitation is related to the aortic diastolic pressure and the effectiveness of adrenaline relates to its peripheral vasopressor effect. Other catecholamines such as noradrenaline may be more efficacious, as could be non-adrenergic vasopressors. Clinical studies are required, however, to evaluate these potential alternatives.

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“…In 1996, Lindner et al reported that plasma AVP concentrations in adults after out-of-hospital car-diac arrest were significantly higher in successfully resuscitated patients compared to unsuccessfully resuscitated patients [6]. Previously studied resuscitation medications such as phenylephrine were proven to be no more effective than epinephrine [7]. Epinephrine, formerly the only first-line medication for treatment of ventricular fibrillation and refractory ventricular tachycardia, has not yet been shown to change outcome and is associated with postresuscitation myocardial dysfunction [8].…”

Section: Role In Cardiopulmonary Resuscitationmentioning

confidence: 99%

Vasopressin: Applications in Clinical Practice

Dyke

Tobias

2004

J Intensive Care Med

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Arginine vasopressin is a peptide produced in the posterior pituitary whose primary physiologic role is fluid homeostasis. Recent investigations have demonstrated a therapeutic role for arginine vasopressin in adult cardiac arrest as well as adult and pediatric vasodilatory shock. We review the physiology of arginine vasopressin and examine the supporting data behind the developing clinical applications of this naturally produced peptide.

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Myocardial oxygen delivery/consumption during cardiopulmonary resuscitation: A comparison of epinephrine and phenylephrine

Cited by 74 publications

References 21 publications

Controversies in Cardiopulmonary Resuscitation: Pediatric Considerations

Controversies in Cardiopulmonary Resuscitation: Pediatric Considerations

Vasopressor Therapy in Cardiac Resuscitation

Vasopressin: Applications in Clinical Practice

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