Vasopressin improves vital organ blood flow during closed-chest cardiopulmonary resuscitation in pigs

Lindner, KH; Prengel, Andreas W.; Pfenninger, E.; Lindner, IM; Hu, Strohmenger; Georgieff, Michael; Lurie, KG

doi:10.1016/0300-9572(95)94128-v

Cited by 16 publications

(22 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite the sensitivity of the search strategy used and the large number of published papers on this subject (485 studies), only six trials satisfied the strict inclusion criteria. In contrast to findings regarding patients with ventricular fibrillation, pulseless electrical activity or asystole, (4,10,23,(33)(34) the results of clinical trials did not support the addition of vasopressin to epinephrine in cardiac arrest resuscitation, except in a subgroup looking at survival rate at 24h. For in-hospital patients, the vasopressin and epinephrine group failed to show any improvement compared with epinephrine for either 1 h survival or survival to hospital discharge.…”

Section: Discussioncontrasting

confidence: 69%

Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis

Jing

Wang

et al. 2010

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 69%

Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis

Jing

Wang

et al. 2010

View full text Add to dashboard Cite

show abstract

“…First, vasopressin will cause intense systemic vasoconstriction despite the presence of extreme acidosis, unlike epinephrine (30). Second, it acts directly on the coronary artery to induce vasodilation (31), which may be beneficial in enhancing coronary perfusion pressure during CA. Finally, in contrast to epinephrine, which significantly increases myocardial oxygen consumption through β 1 -adrenergic receptor activation, vasopressin enhances myocardial oxygen delivery (32) and may increase contractility by preserving myocardial energetics (33).…”

Section: Vasopressin Appears a Plausible Alternative To Epinephrinementioning

confidence: 99%

Vasopressin improves survival compared with epinephrine in a neonatal piglet model of asphyxial cardiac arrest

et al. 2014

View full text Add to dashboard Cite

Background: Epinephrine is a component of all resuscitation algorithms. Vasopressin is a pulmonary vasodilator and systemic vasopressor. We investigated the effect of epinephrine vs. vasopressin on survival and hemodynamics after neonatal porcine cardiac arrest (CA). Methods: A 4-min asphyxial CA was induced, after which cardiopulmonary resuscitation (CPR) was commenced. Animals were randomized to low-(LDE: 0.01 mg/kg) or high-dose epinephrine (HDE: 0.03 mg/kg), low-(LDV: 0.2 U/kg) or high-dose vasopressin (HDV: 0.4 U/kg), or control (saline). Clinical and echocardiography indexes were monitored. results: Sixty-nine animals were randomized. Survival was greater in HDV (n = 8 (89%); P < 0.05 ANOVA) vs. control (n = 7 (43%)) and LDE (n = 5 (36%)) but not vs. HDE (n = 7 (64%)) or LDV (n = 6 (75%)). Animals resuscitated with LDE required more shocks (2.5 (interquartile range: 2-6); P < 0.05) and higher doses of energy (15 J (interquartile range: 10-20); P < 0.05). Left ventricular output was comparable between groups, but a greater increase in superior vena caval flow was seen after HDV (P < 0.001 vs. control, LDE, and HDE). Plasma troponin was greatest in the HDE group (P < 0.05 vs. control and HDV). conclusion: Vasopressin results in improved survival, lower postresuscitation troponin, and less hemodynamic compromise after CA in newborn piglets. Vasopressin may be a candidate for testing in human neonates. t he need for active neonatal resuscitation is common with an incidence of 5-10%, although there is likely to be regional variability (1). Guidelines for drug use in neonatal resuscitation guidelines are based on extrapolations from adult literature. Pressors, almost invariably epinephrine, are recommended as core therapy during cardiopulmonary resuscitation (CPR) in order to enhance systemic perfusion (especially cerebral and coronary perfusion) by maintaining vascular tone while forward flow is generated by chest compressions. Epinephrine, although an integral part of every published protocol for neonatal resuscitation, may be associated with adverse effects (2-6); similar concerns exist in pediatric and adult cardiac arrest (CA). However, because of concerns associated with epinephrine (2,7), vasopressin was studied in the setting of asystolic CA. Vasopressin is an intense systemic vasoconstrictor, which may explain why it increases cerebral (and systemic) perfusion during experimental cardiac massage, as well as increasing cerebral oxygenation, neurological outcome, and resuscitation success following experimental .Vasopressin was first proposed as a resuscitation agent after endogenous vasopressin levels were found to be higher in successfully resuscitated patients compared with those who died (13). Evidence from a large, adult, multicenter, randomized controlled trial suggests it to be superior to epinephrine, when the nature of the CA was primary asystole (14). For the following reasons, vasopressin may be a good candidate for pressor support during CPR. First, CA in neonates is almost always due to asphy...

show abstract

“…Th ese studies consistently demonstrated that vasopressin doses between 0.4 and 0.8 U/kg led to a signifi cantly higher coronary perfusion pressure and myocardial blood fl ow than epinephrine and were associated with a higher percentage of successfully resusci tated animals [20][21][22][23]. However, adverse cardiovascular eff ects from vasopressin have been described as well.…”

Section: Vasopressinmentioning

confidence: 97%

Is There Still a Place for Vasopressors in the Treatment of Cardiac Arrest?

Sandroni¹,

Cavallaro²,

Antonelli³

2012

Annual Update in Intensive Care and Emergency Medicine 2012

View full text Add to dashboard Cite

show abstract

Vasopressin improves vital organ blood flow during closed-chest cardiopulmonary resuscitation in pigs

Cited by 16 publications

References 0 publications

Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis

Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis

Vasopressin improves survival compared with epinephrine in a neonatal piglet model of asphyxial cardiac arrest

Is There Still a Place for Vasopressors in the Treatment of Cardiac Arrest?

Contact Info

Product

Resources

About