Endothelin-1 elevates regional cerebral perfusion during prolonged ventricular fibrillation cardiac arrest in pigs

Since adrenaline (epinephrine) also has negative effects during and after cardiopulmonary resuscitation (CPR) a non-adrenergic vasoconstrictor like endothelin might be an alternative to increase vital organ blood flow. We studied the effect of different doses of endothelin-1 compared with adrenaline...

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Veröffentlicht in:Resuscitation 2002-12, Vol.55 (3), p.317-327
Hauptverfasser: Holzer, Michael, Sterz, Fritz, Behringer, Wilhelm, Oschatz, Elisabeth, Kofler, Julia, Eisenburger, Philip, Kittler, Harald, Konschitzky, Reinhard, Laggner, Anton N.
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Sprache:eng
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Zusammenfassung:Since adrenaline (epinephrine) also has negative effects during and after cardiopulmonary resuscitation (CPR) a non-adrenergic vasoconstrictor like endothelin might be an alternative to increase vital organ blood flow. We studied the effect of different doses of endothelin-1 compared with adrenaline on the ability to resuscitate, cerebral and myocardial blood flow (MBF) in a closed chest cardiac arrest pig model. After 5 min of ventricular fibrillation, CPR with a ventilator and a mechanical compression device was started. At 10 min, 31 pigs were randomized to receive a single dose of endothelin-1 50, 100 or 200 μg or repeated doses of adrenaline 0.04 mg kg −1 or saline every 3 min. After 25 min, the pigs were defibrillated to achieve restoration of spontaneous circulation. Blood flow was measured with the fluorescent microsphere method. In animals receiving endothelin-1 50, 100 and 200 μg the cerebral blood flow (CBF) increased from median 28 (25th; 75th quartile: 16; 40), 32 (15; 48) and 17 (4; 65) to 36 (31; 54), 47 (39; 57) and 63 (35; 83) ml min −1 per 100 g, respectively, 6 min after drug administration ( P
ISSN:0300-9572
1873-1570
DOI:10.1016/S0300-9572(02)00211-3