The effects of epinephrine/norepinephrine on end-tidal carbon dioxide concentration, coronary perfusion pressure and pulmonary arterial blood flow during cardiopulmonary resuscitation

Lindberg, Lars; Liao, Quiming; Steen, Stig

doi:10.1016/s0300-9572(99)00129-x

Cited by 62 publications

(30 citation statements)

References 19 publications

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“…29 However, etCO 2 is dependent on effective minute ventilation and is also influenced by the administration of vasoactive drugs. 30,31 Interestingly, in a recent conference abstract Engel et al showed that the initial, the overall, the last five-minutes and the final value of rSO 2 correlated better with ROSC than the respective values of etCO 2 . 32 The etCO 2 has been also used as a tool for evaluation of the efficacy of chest compressions, and in this regards also rSO 2 is currently investigated for its correlation with the efficacy of resuscitation.…”

Section: Discussionmentioning

confidence: 99%

Cerebral oximetry and return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis

Sanfilippo¹,

Serena²,

Corredor³

et al. 2015

Resuscitation

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Section: Discussionmentioning

confidence: 99%

Cerebral oximetry and return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis

Sanfilippo¹,

Serena²,

Corredor³

et al. 2015

Resuscitation

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“…One animal and one human study showed that high doses of adrenaline (>1 mg) cause pulmonary ventilation/perfusion defects due to pulmonary blood flow redistribution, decreasing ETCO 2 [52,77]. In another study, adrenaline increased CPP and myocardial blood flow, but decreased cardiac output [39].…”

Section: Limitations Of the Methodsmentioning

confidence: 97%

“…Ward et al compared the use of mechanical and manual chest compressions during cardiac arrest based on continuous monitoring of ETCO 2 and reported that cardiac output produced with mechanical chest compressions is increased compared to manual compressions [24]. However, it should be noted that many potential confounding factors may affect the levels of expired end-tidal ETCO 2 during cardiac arrest, such as the cause of the arrest, the initial heart rhythm, the early onset of CPR, the rescuer fatigue, and the administration of drugs [28,[36][37][38][39]. Of note, when vasopressors are injected, the ETCO 2 concentration may decrease, concomitant with an increase in coronary perfusion pressure [11,39].…”

Section: Effectiveness Of Chest Compressionsmentioning

confidence: 99%

A Review of Carbon Dioxide Monitoring During Adult Cardiopulmonary Resuscitation

Pantazopoulos

Xanthos

Pantazopoulos

et al. 2015

Heart, Lung and Circulation

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Although high quality cardiopulmonary resuscitation is one of the most significant factors related to favourable outcome, its quality depends on many components, such as airway management, compression depth and chest recoil, hands-off time, and early defibrillation. The most common way of controlling the resuscitation efforts is monitoring of end-tidal carbon dioxide. The International Liaison Committee on Resuscitation suggests this method both for in-hospital and out-of-hospital cardiac arrest. However, despite the abundant human and animal studies supporting the usefulness of end-tidal carbon dioxide, its optimal values during cardiopulmonary resuscitation remain controversial. In this review, the advantages and effectiveness of end-tidal carbon dioxide during cardiopulmonary resuscitation are discussed and specific target values are suggested based on the available literature.

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“…However, survival was superior with adrenaline than with controls. Lindberg et al [37], in 18 pigs with VF after sternotomy and closure, showed that while adrenaline (or noradrenaline) increased CPP during the arrest up to 45 mmHg compared to only 7 mmHg for controls, it significantly impaired cardiac output and oxygen delivery after successful resuscitation. Chen et al [38], in 47 rabbits with arrest after ET tube clamping, found that adrenaline increased CPP from 4 to 38 mmHg whereas vasopressin failed to do this.…”

Section: Administration Of Adrenaline (Epinephrine)mentioning

confidence: 99%

Guideline for resuscitation in cardiac arrest after cardiac surgery

Dunning

Fabbri

Kolh³

et al. 2009

European Journal of Cardio-Thoracic Surgery

154

120

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The Clinical Guidelines Committee of the European Association for Cardio-Thoracic Surgery provides this professional view on resuscitation in cardiac arrest after cardiac surgery. This document was created using a multimodal methodology for evidence generation including the extrapolation of existing guidelines from the International Liaison Committee on Resuscitation where possible, our own structured literature reviews on issues particular to cardiac surgery, an international survey on resuscitation hosted by CTSNet and manikin simulations of potential protocols. This protocol differs from existing generic guidelines in a number of areas, the most import of which are the following: successful treatment of cardiac arrest after cardiac surgery is a multi-practitioner activity with six key roles that should be allocated and rehearsed on a regular basis; in ventricular fibrillation, three sequential attempts at defibrillation (where immediately available) should precede external cardiac massage; in asystole or extreme bradycardia, pacing (where immediately available) should precede external cardiac massage; where the above measures fail, and in pulseless electrical activity, early resternotomy is advocated; adrenaline should not be routinely given; protocols for excluding reversible airway and breathing complications and for safe emergency resternotomy are given. This guideline is subject to continuous informal review, and when new evidence becomes available.

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The effects of epinephrine/norepinephrine on end-tidal carbon dioxide concentration, coronary perfusion pressure and pulmonary arterial blood flow during cardiopulmonary resuscitation

Cited by 62 publications

References 19 publications

Cerebral oximetry and return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis

Cerebral oximetry and return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis

A Review of Carbon Dioxide Monitoring During Adult Cardiopulmonary Resuscitation

Guideline for resuscitation in cardiac arrest after cardiac surgery

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