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 |
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| creator | Holzer, Michael Sterz, Fritz Behringer, Wilhelm Oschatz, Elisabeth Kofler, Julia Eisenburger, Philip Kittler, Harald Konschitzky, Reinhard Laggner, Anton N. |
| description | 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 |
| doi_str_mv | 10.1016/S0300-9572(02)00211-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72730186</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0300957202002113</els_id><sourcerecordid>72730186</sourcerecordid><originalsourceid>FETCH-LOGICAL-c391t-bad78005f1c93425cb477f7295c0f691f42a3c804d925fa116ed8bada67dccdf3</originalsourceid><addsrcrecordid>eNqFkNFqFDEUhoModlt9BCU3Sr2YepLMTGauipRqC4VeqNchk5yskdnMejKz4NubcRd7KQROCN9_8vMx9kbAlQDRfvwKCqDqGy0vQX4AkEJU6hnbiE6rSjQanrPNP-SMnef8EwBU0-uX7EzIuumg7TeMbpOf5h84xlQJjiMe7IyZE27jlOzIHRIOVC57pLDk8sj9QjFt-Z6mcUpb9PyAaaboltESD3GgOI52XklnyUfruCXCPPOY-D5u8yv2Itgx4-vTvGDfP99-u7mrHh6_3N98eqic6sVcDdbrDqAJwvWqlo0baq2Dln3jILS9CLW0ynVQ-142wQrRou9KyLbaO-eDumDvj3tL019LKWB2MTss5RJOSzZaagWiawvYHEFHU86Ewewp7iz9NgLMKtv8lW1WkwbKWWUbVXJvTx8sww79U-pktwDvToDNzo6BbHIxP3E11FJ3K3d95LDoOEQkk13E5NBHQjcbP8X_VPkDunmeHw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72730186</pqid></control><display><type>article</type><title>Endothelin-1 elevates regional cerebral perfusion during prolonged ventricular fibrillation cardiac arrest in pigs</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Holzer, Michael ; Sterz, Fritz ; Behringer, Wilhelm ; Oschatz, Elisabeth ; Kofler, Julia ; Eisenburger, Philip ; Kittler, Harald ; Konschitzky, Reinhard ; Laggner, Anton N.</creator><creatorcontrib>Holzer, Michael ; Sterz, Fritz ; Behringer, Wilhelm ; Oschatz, Elisabeth ; Kofler, Julia ; Eisenburger, Philip ; Kittler, Harald ; Konschitzky, Reinhard ; Laggner, Anton N.</creatorcontrib><description><![CDATA[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<0.05 endothelin-1 50 μg vs. Control,
P<0.01 endothelin-1 100 and 200 μg vs. Control). At the same time CBF decreased in the control and adrenaline group from 36 (21; 41) and 39 (15; 50) to 12 (2; 25) and 24 (15; 26) ml min
−1 per 100 g, respectively, (
P<0.05 adrenaline vs. endothelin-1 200 μg). There was no difference in MBF between the treatment groups despite a higher coronary perfusion pressure (CoPP) in the endothelin-1 groups. Restoration of spontaneous circulation could be only achieved in the endothelin-1 50 μg (3 of 7; 43%) and 100 μg (5 of 7; 71%) group. This study suggests that endothelin-1 enhances CBF during CPR better than adrenaline and increases resuscitation success.
Como a adrenalina tem efeitos negativos durante e após a reanimação cardio-pulmonar (CPR), um vasoconstritor não adrenérgico como a endotelina pode ser uma alternativa para aumentar o fluxo sanguı́neo aos orgãos vitais. Estudamos os efeitos de diferentes doses de endotelina-1 quando comparadas com adrenalina na capacidade para reanimar e nas repercussões sobre o fluxo sanguı́neo cerebral e miocárdico num modelo de paragem cardı́aca em tórax fechado de porco. Depois de 5 minutos de fibrilhação ventricular, era iniciado CPR com um ventilador e com um sistema de compressão mecânica. Aos 10 minutos, 31 porcos foram randomizados para receber uma dose única de endotelina-1 de 50, 100 ou 200 g ou para receber doses múltiplas de adrenalina de 0.04 mg/kg, ou soro fisiológico a cada 3 minutos. Ao fim de 25 minutos os porcos foram desfibrilhados para conseguir a recuperação de circulação espontânea. O fluxo sanguı́neo foi medido com o método das microsferas fluorescentes. Nos animais que recebiam 50, 100 ou 200 μg de endotelina-1 o fluxo cerebral (CBF) subiu de uma média de 28 (25°, 75° quartil: 16; 40), 32 (15; 48) e 17 (4; 65) para 36 (31; 54), 47 (39; 57) e 63 (35; 83) ml/min/100g respectivamente 6 minutos após a administração do fármaco (
P<0.05 endotelina-1 50 g vs. Controle,
P<0.01 endotelina-1 100 e 200 g vs. controle). Em simultâneo o fluxo sanguı́neo cerebral diminuiu nos grupos controle e adrenalina de 36 (21; 41) e 39 (15; 50) para 12 (2; 25) e 24 (15; 26) ml/min/100 g respectivamente, (
P<0.05 adrenalina vs. Endotelina-1 200 μg). Não havia diferenças no fluxo sanguı́neo miocárdico entre os grupos de tratamento apesar de haver uma maior pressão de perfusão coronária (CoPP) nos grupos de endotelina-1. A restauração da circulação espontânea só pode ser alcançada nos grupos endotelina-1 50 g (3 em 7; 43%) e 100 g (5 em 7; 71%). Este estudo sugere que a endotelina-1 melhora o fluxo sanguı́neo cerebral durante a reanimação cárdio-pulmonar mais que a adrenalina e aumenta o sucesso da reanimação.
Dado que la adrenalina tiene también efectos negativos durante y después de la reanimación cardiopulmonar (RCP), un vasoconstrictor no adrenérgico como la endotelina podrı́a ser una alternativa para mejorar el flujo de sangre a órganos vitales. Estudiamos el efecto de diferentes dosis de endotelina-1 comparándola con adrenalina en la capacidad de resucitar, flujo cerebral y miocárdico (MBF) en un modelo porcino de paro cardı́aco con tórax cerrado. Después de 5 minutos de fibrilación ventricular se inició RCP con un ventilador y un aparato de compresión mecánica. A los 10 minutos, 31 cerdos fueron randomizados para recibir una dosis única de endotelina-1 de 50, 100 ó 200 μg o dosis repetidas de adrenalina de 0.04 mg kg
−1 o solución salina cada 3 minutos. Después de 25 minutos, los cerdos fueron desfibrilados para obtener restablecimiento de la circulación espontánea. El flujo sanguı́neo fue medido con el método de micro esferas fluorescentes. En los animales que recibieron la endotelina-1 a 50, 100 ó 200 μg el flujo cerebral (CBF) aumentó de una mediana de 28 (cuartiles 25°; 75°: 16; 40), 32 (15; 48) y 17 (4; 65) a 36 (31; 54), 47 (39; 57) y 63 (35; 83)ml min
−1 por 100g respectivamente, 6 minutos después de la administración de la droga (
P<0.05 endoltelin-1 50 μg vs grupo control,
P<0.01 endotelina-1 a 100 y 200 μg versus control). Al mismo tiempo la CBS bajó en los grupos control y adrenalina de 36 (21; 41) y 39(15; 50) a 12 (2; 25) y 24 (15; 26) ml min
−1 por 100 gr, respectivamente, (
P<0.05 adrenalina versus endotelina-1 200 μg). No hubo diferencia en MBF entre los grupos de tratamiento pese a haber mayor presión de perfusión coronaria (CoPP) en el grupo de endotelina-1. El restablecimiento de circulación espontánea solo pudo ser alcanzada en los grupos de endotelina-1 de 50 μg (3 de 7; 43%) y de 100 μg (5 de 7; 71%). Este estudio sugiere que la endotelina-1 aumenta la CBF durante la RCP en forma superior a la adrenalina y aumenta el éxito de la resucitación.]]></description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/S0300-9572(02)00211-3</identifier><identifier>PMID: 12458069</identifier><identifier>CODEN: RSUSBS</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject><![CDATA[Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Animals ; Biological and medical sciences ; Blood Pressure - drug effects ; Brain - blood supply ; Cardiopulmonary resuscitation ; Cardiopulmonary Resuscitation - methods ; Cerebral blood flow ; Coronary Circulation - drug effects ; Coronary perfusion pressure ; Double Bind Interaction ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Endotelina-1 ; Endothelin-1 ; Endothelin-1 - administration & dosage ; Endothelin-1 - pharmacology ; Endothelin-1 - therapeutic use ; Epinephrine - administration & dosage ; Epinephrine - pharmacology ; Epinephrine - therapeutic use ; Fibrilación ventricular ; Fibrilhação ventricular ; Flujo sanguı́neo cerebral ; Flujo sanguı́neo miocárdico ; Fluxo sanguı́neo cerebral ; Fluxo sanguı́neo miocárdico ; Heart Arrest - complications ; Heart Arrest - drug therapy ; Intensive care medicine ; Medical sciences ; Myocardial blood flow ; Presión de perfusión coronaria ; Pressão de perfusão coronária ; Prospective Studies ; Random Allocation ; Reanimación cardiopulmonar ; Reanimação cárdio-pulmonar ; Regional Blood Flow - drug effects ; Swine ; Terapia vasopresora ; Terapêutica vasopressora ; Vasoconstrictor Agents - administration & dosage ; Vasoconstrictor Agents - pharmacology ; Vasoconstrictor Agents - therapeutic use ; Vasopressor therapy ; Ventricular fibrillation ; Ventricular Fibrillation - complications ; Ventricular Fibrillation - drug therapy]]></subject><ispartof>Resuscitation, 2002-12, Vol.55 (3), p.317-327</ispartof><rights>2002</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-bad78005f1c93425cb477f7295c0f691f42a3c804d925fa116ed8bada67dccdf3</citedby><cites>FETCH-LOGICAL-c391t-bad78005f1c93425cb477f7295c0f691f42a3c804d925fa116ed8bada67dccdf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0300-9572(02)00211-3$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14042789$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12458069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Holzer, Michael</creatorcontrib><creatorcontrib>Sterz, Fritz</creatorcontrib><creatorcontrib>Behringer, Wilhelm</creatorcontrib><creatorcontrib>Oschatz, Elisabeth</creatorcontrib><creatorcontrib>Kofler, Julia</creatorcontrib><creatorcontrib>Eisenburger, Philip</creatorcontrib><creatorcontrib>Kittler, Harald</creatorcontrib><creatorcontrib>Konschitzky, Reinhard</creatorcontrib><creatorcontrib>Laggner, Anton N.</creatorcontrib><title>Endothelin-1 elevates regional cerebral perfusion during prolonged ventricular fibrillation cardiac arrest in pigs</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description><![CDATA[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<0.05 endothelin-1 50 μg vs. Control,
P<0.01 endothelin-1 100 and 200 μg vs. Control). At the same time CBF decreased in the control and adrenaline group from 36 (21; 41) and 39 (15; 50) to 12 (2; 25) and 24 (15; 26) ml min
−1 per 100 g, respectively, (
P<0.05 adrenaline vs. endothelin-1 200 μg). There was no difference in MBF between the treatment groups despite a higher coronary perfusion pressure (CoPP) in the endothelin-1 groups. Restoration of spontaneous circulation could be only achieved in the endothelin-1 50 μg (3 of 7; 43%) and 100 μg (5 of 7; 71%) group. This study suggests that endothelin-1 enhances CBF during CPR better than adrenaline and increases resuscitation success.
Como a adrenalina tem efeitos negativos durante e após a reanimação cardio-pulmonar (CPR), um vasoconstritor não adrenérgico como a endotelina pode ser uma alternativa para aumentar o fluxo sanguı́neo aos orgãos vitais. Estudamos os efeitos de diferentes doses de endotelina-1 quando comparadas com adrenalina na capacidade para reanimar e nas repercussões sobre o fluxo sanguı́neo cerebral e miocárdico num modelo de paragem cardı́aca em tórax fechado de porco. Depois de 5 minutos de fibrilhação ventricular, era iniciado CPR com um ventilador e com um sistema de compressão mecânica. Aos 10 minutos, 31 porcos foram randomizados para receber uma dose única de endotelina-1 de 50, 100 ou 200 g ou para receber doses múltiplas de adrenalina de 0.04 mg/kg, ou soro fisiológico a cada 3 minutos. Ao fim de 25 minutos os porcos foram desfibrilhados para conseguir a recuperação de circulação espontânea. O fluxo sanguı́neo foi medido com o método das microsferas fluorescentes. Nos animais que recebiam 50, 100 ou 200 μg de endotelina-1 o fluxo cerebral (CBF) subiu de uma média de 28 (25°, 75° quartil: 16; 40), 32 (15; 48) e 17 (4; 65) para 36 (31; 54), 47 (39; 57) e 63 (35; 83) ml/min/100g respectivamente 6 minutos após a administração do fármaco (
P<0.05 endotelina-1 50 g vs. Controle,
P<0.01 endotelina-1 100 e 200 g vs. controle). Em simultâneo o fluxo sanguı́neo cerebral diminuiu nos grupos controle e adrenalina de 36 (21; 41) e 39 (15; 50) para 12 (2; 25) e 24 (15; 26) ml/min/100 g respectivamente, (
P<0.05 adrenalina vs. Endotelina-1 200 μg). Não havia diferenças no fluxo sanguı́neo miocárdico entre os grupos de tratamento apesar de haver uma maior pressão de perfusão coronária (CoPP) nos grupos de endotelina-1. A restauração da circulação espontânea só pode ser alcançada nos grupos endotelina-1 50 g (3 em 7; 43%) e 100 g (5 em 7; 71%). Este estudo sugere que a endotelina-1 melhora o fluxo sanguı́neo cerebral durante a reanimação cárdio-pulmonar mais que a adrenalina e aumenta o sucesso da reanimação.
Dado que la adrenalina tiene también efectos negativos durante y después de la reanimación cardiopulmonar (RCP), un vasoconstrictor no adrenérgico como la endotelina podrı́a ser una alternativa para mejorar el flujo de sangre a órganos vitales. Estudiamos el efecto de diferentes dosis de endotelina-1 comparándola con adrenalina en la capacidad de resucitar, flujo cerebral y miocárdico (MBF) en un modelo porcino de paro cardı́aco con tórax cerrado. Después de 5 minutos de fibrilación ventricular se inició RCP con un ventilador y un aparato de compresión mecánica. A los 10 minutos, 31 cerdos fueron randomizados para recibir una dosis única de endotelina-1 de 50, 100 ó 200 μg o dosis repetidas de adrenalina de 0.04 mg kg
−1 o solución salina cada 3 minutos. Después de 25 minutos, los cerdos fueron desfibrilados para obtener restablecimiento de la circulación espontánea. El flujo sanguı́neo fue medido con el método de micro esferas fluorescentes. En los animales que recibieron la endotelina-1 a 50, 100 ó 200 μg el flujo cerebral (CBF) aumentó de una mediana de 28 (cuartiles 25°; 75°: 16; 40), 32 (15; 48) y 17 (4; 65) a 36 (31; 54), 47 (39; 57) y 63 (35; 83)ml min
−1 por 100g respectivamente, 6 minutos después de la administración de la droga (
P<0.05 endoltelin-1 50 μg vs grupo control,
P<0.01 endotelina-1 a 100 y 200 μg versus control). Al mismo tiempo la CBS bajó en los grupos control y adrenalina de 36 (21; 41) y 39(15; 50) a 12 (2; 25) y 24 (15; 26) ml min
−1 por 100 gr, respectivamente, (
P<0.05 adrenalina versus endotelina-1 200 μg). No hubo diferencia en MBF entre los grupos de tratamiento pese a haber mayor presión de perfusión coronaria (CoPP) en el grupo de endotelina-1. El restablecimiento de circulación espontánea solo pudo ser alcanzada en los grupos de endotelina-1 de 50 μg (3 de 7; 43%) y de 100 μg (5 de 7; 71%). Este estudio sugiere que la endotelina-1 aumenta la CBF durante la RCP en forma superior a la adrenalina y aumenta el éxito de la resucitación.]]></description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure - drug effects</subject><subject>Brain - blood supply</subject><subject>Cardiopulmonary resuscitation</subject><subject>Cardiopulmonary Resuscitation - methods</subject><subject>Cerebral blood flow</subject><subject>Coronary Circulation - drug effects</subject><subject>Coronary perfusion pressure</subject><subject>Double Bind Interaction</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Endotelina-1</subject><subject>Endothelin-1</subject><subject>Endothelin-1 - administration & dosage</subject><subject>Endothelin-1 - pharmacology</subject><subject>Endothelin-1 - therapeutic use</subject><subject>Epinephrine - administration & dosage</subject><subject>Epinephrine - pharmacology</subject><subject>Epinephrine - therapeutic use</subject><subject>Fibrilación ventricular</subject><subject>Fibrilhação ventricular</subject><subject>Flujo sanguı&#x0301;neo cerebral</subject><subject>Flujo sanguı&#x0301;neo miocárdico</subject><subject>Fluxo sanguı&#x0301;neo cerebral</subject><subject>Fluxo sanguı&#x0301;neo miocárdico</subject><subject>Heart Arrest - complications</subject><subject>Heart Arrest - drug therapy</subject><subject>Intensive care medicine</subject><subject>Medical sciences</subject><subject>Myocardial blood flow</subject><subject>Presión de perfusión coronaria</subject><subject>Pressão de perfusão coronária</subject><subject>Prospective Studies</subject><subject>Random Allocation</subject><subject>Reanimación cardiopulmonar</subject><subject>Reanimação cárdio-pulmonar</subject><subject>Regional Blood Flow - drug effects</subject><subject>Swine</subject><subject>Terapia vasopresora</subject><subject>Terapêutica vasopressora</subject><subject>Vasoconstrictor Agents - administration & dosage</subject><subject>Vasoconstrictor Agents - pharmacology</subject><subject>Vasoconstrictor Agents - therapeutic use</subject><subject>Vasopressor therapy</subject><subject>Ventricular fibrillation</subject><subject>Ventricular Fibrillation - complications</subject><subject>Ventricular Fibrillation - drug therapy</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkNFqFDEUhoModlt9BCU3Sr2YepLMTGauipRqC4VeqNchk5yskdnMejKz4NubcRd7KQROCN9_8vMx9kbAlQDRfvwKCqDqGy0vQX4AkEJU6hnbiE6rSjQanrPNP-SMnef8EwBU0-uX7EzIuumg7TeMbpOf5h84xlQJjiMe7IyZE27jlOzIHRIOVC57pLDk8sj9QjFt-Z6mcUpb9PyAaaboltESD3GgOI52XklnyUfruCXCPPOY-D5u8yv2Itgx4-vTvGDfP99-u7mrHh6_3N98eqic6sVcDdbrDqAJwvWqlo0baq2Dln3jILS9CLW0ynVQ-142wQrRou9KyLbaO-eDumDvj3tL019LKWB2MTss5RJOSzZaagWiawvYHEFHU86Ewewp7iz9NgLMKtv8lW1WkwbKWWUbVXJvTx8sww79U-pktwDvToDNzo6BbHIxP3E11FJ3K3d95LDoOEQkk13E5NBHQjcbP8X_VPkDunmeHw</recordid><startdate>20021201</startdate><enddate>20021201</enddate><creator>Holzer, Michael</creator><creator>Sterz, Fritz</creator><creator>Behringer, Wilhelm</creator><creator>Oschatz, Elisabeth</creator><creator>Kofler, Julia</creator><creator>Eisenburger, Philip</creator><creator>Kittler, Harald</creator><creator>Konschitzky, Reinhard</creator><creator>Laggner, Anton N.</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20021201</creationdate><title>Endothelin-1 elevates regional cerebral perfusion during prolonged ventricular fibrillation cardiac arrest in pigs</title><author>Holzer, Michael ; Sterz, Fritz ; Behringer, Wilhelm ; Oschatz, Elisabeth ; Kofler, Julia ; Eisenburger, Philip ; Kittler, Harald ; Konschitzky, Reinhard ; Laggner, Anton N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-bad78005f1c93425cb477f7295c0f691f42a3c804d925fa116ed8bada67dccdf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure - drug effects</topic><topic>Brain - blood supply</topic><topic>Cardiopulmonary resuscitation</topic><topic>Cardiopulmonary Resuscitation - methods</topic><topic>Cerebral blood flow</topic><topic>Coronary Circulation - drug effects</topic><topic>Coronary perfusion pressure</topic><topic>Double Bind Interaction</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Endotelina-1</topic><topic>Endothelin-1</topic><topic>Endothelin-1 - administration & dosage</topic><topic>Endothelin-1 - pharmacology</topic><topic>Endothelin-1 - therapeutic use</topic><topic>Epinephrine - administration & dosage</topic><topic>Epinephrine - pharmacology</topic><topic>Epinephrine - therapeutic use</topic><topic>Fibrilación ventricular</topic><topic>Fibrilhação ventricular</topic><topic>Flujo sanguı&#x0301;neo cerebral</topic><topic>Flujo sanguı&#x0301;neo miocárdico</topic><topic>Fluxo sanguı&#x0301;neo cerebral</topic><topic>Fluxo sanguı&#x0301;neo miocárdico</topic><topic>Heart Arrest - complications</topic><topic>Heart Arrest - drug therapy</topic><topic>Intensive care medicine</topic><topic>Medical sciences</topic><topic>Myocardial blood flow</topic><topic>Presión de perfusión coronaria</topic><topic>Pressão de perfusão coronária</topic><topic>Prospective Studies</topic><topic>Random Allocation</topic><topic>Reanimación cardiopulmonar</topic><topic>Reanimação cárdio-pulmonar</topic><topic>Regional Blood Flow - drug effects</topic><topic>Swine</topic><topic>Terapia vasopresora</topic><topic>Terapêutica vasopressora</topic><topic>Vasoconstrictor Agents - administration & dosage</topic><topic>Vasoconstrictor Agents - pharmacology</topic><topic>Vasoconstrictor Agents - therapeutic use</topic><topic>Vasopressor therapy</topic><topic>Ventricular fibrillation</topic><topic>Ventricular Fibrillation - complications</topic><topic>Ventricular Fibrillation - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Holzer, Michael</creatorcontrib><creatorcontrib>Sterz, Fritz</creatorcontrib><creatorcontrib>Behringer, Wilhelm</creatorcontrib><creatorcontrib>Oschatz, Elisabeth</creatorcontrib><creatorcontrib>Kofler, Julia</creatorcontrib><creatorcontrib>Eisenburger, Philip</creatorcontrib><creatorcontrib>Kittler, Harald</creatorcontrib><creatorcontrib>Konschitzky, Reinhard</creatorcontrib><creatorcontrib>Laggner, Anton N.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Holzer, Michael</au><au>Sterz, Fritz</au><au>Behringer, Wilhelm</au><au>Oschatz, Elisabeth</au><au>Kofler, Julia</au><au>Eisenburger, Philip</au><au>Kittler, Harald</au><au>Konschitzky, Reinhard</au><au>Laggner, Anton N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endothelin-1 elevates regional cerebral perfusion during prolonged ventricular fibrillation cardiac arrest in pigs</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2002-12-01</date><risdate>2002</risdate><volume>55</volume><issue>3</issue><spage>317</spage><epage>327</epage><pages>317-327</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><coden>RSUSBS</coden><abstract><![CDATA[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<0.05 endothelin-1 50 μg vs. Control,
P<0.01 endothelin-1 100 and 200 μg vs. Control). At the same time CBF decreased in the control and adrenaline group from 36 (21; 41) and 39 (15; 50) to 12 (2; 25) and 24 (15; 26) ml min
−1 per 100 g, respectively, (
P<0.05 adrenaline vs. endothelin-1 200 μg). There was no difference in MBF between the treatment groups despite a higher coronary perfusion pressure (CoPP) in the endothelin-1 groups. Restoration of spontaneous circulation could be only achieved in the endothelin-1 50 μg (3 of 7; 43%) and 100 μg (5 of 7; 71%) group. This study suggests that endothelin-1 enhances CBF during CPR better than adrenaline and increases resuscitation success.
Como a adrenalina tem efeitos negativos durante e após a reanimação cardio-pulmonar (CPR), um vasoconstritor não adrenérgico como a endotelina pode ser uma alternativa para aumentar o fluxo sanguı́neo aos orgãos vitais. Estudamos os efeitos de diferentes doses de endotelina-1 quando comparadas com adrenalina na capacidade para reanimar e nas repercussões sobre o fluxo sanguı́neo cerebral e miocárdico num modelo de paragem cardı́aca em tórax fechado de porco. Depois de 5 minutos de fibrilhação ventricular, era iniciado CPR com um ventilador e com um sistema de compressão mecânica. Aos 10 minutos, 31 porcos foram randomizados para receber uma dose única de endotelina-1 de 50, 100 ou 200 g ou para receber doses múltiplas de adrenalina de 0.04 mg/kg, ou soro fisiológico a cada 3 minutos. Ao fim de 25 minutos os porcos foram desfibrilhados para conseguir a recuperação de circulação espontânea. O fluxo sanguı́neo foi medido com o método das microsferas fluorescentes. Nos animais que recebiam 50, 100 ou 200 μg de endotelina-1 o fluxo cerebral (CBF) subiu de uma média de 28 (25°, 75° quartil: 16; 40), 32 (15; 48) e 17 (4; 65) para 36 (31; 54), 47 (39; 57) e 63 (35; 83) ml/min/100g respectivamente 6 minutos após a administração do fármaco (
P<0.05 endotelina-1 50 g vs. Controle,
P<0.01 endotelina-1 100 e 200 g vs. controle). Em simultâneo o fluxo sanguı́neo cerebral diminuiu nos grupos controle e adrenalina de 36 (21; 41) e 39 (15; 50) para 12 (2; 25) e 24 (15; 26) ml/min/100 g respectivamente, (
P<0.05 adrenalina vs. Endotelina-1 200 μg). Não havia diferenças no fluxo sanguı́neo miocárdico entre os grupos de tratamento apesar de haver uma maior pressão de perfusão coronária (CoPP) nos grupos de endotelina-1. A restauração da circulação espontânea só pode ser alcançada nos grupos endotelina-1 50 g (3 em 7; 43%) e 100 g (5 em 7; 71%). Este estudo sugere que a endotelina-1 melhora o fluxo sanguı́neo cerebral durante a reanimação cárdio-pulmonar mais que a adrenalina e aumenta o sucesso da reanimação.
Dado que la adrenalina tiene también efectos negativos durante y después de la reanimación cardiopulmonar (RCP), un vasoconstrictor no adrenérgico como la endotelina podrı́a ser una alternativa para mejorar el flujo de sangre a órganos vitales. Estudiamos el efecto de diferentes dosis de endotelina-1 comparándola con adrenalina en la capacidad de resucitar, flujo cerebral y miocárdico (MBF) en un modelo porcino de paro cardı́aco con tórax cerrado. Después de 5 minutos de fibrilación ventricular se inició RCP con un ventilador y un aparato de compresión mecánica. A los 10 minutos, 31 cerdos fueron randomizados para recibir una dosis única de endotelina-1 de 50, 100 ó 200 μg o dosis repetidas de adrenalina de 0.04 mg kg
−1 o solución salina cada 3 minutos. Después de 25 minutos, los cerdos fueron desfibrilados para obtener restablecimiento de la circulación espontánea. El flujo sanguı́neo fue medido con el método de micro esferas fluorescentes. En los animales que recibieron la endotelina-1 a 50, 100 ó 200 μg el flujo cerebral (CBF) aumentó de una mediana de 28 (cuartiles 25°; 75°: 16; 40), 32 (15; 48) y 17 (4; 65) a 36 (31; 54), 47 (39; 57) y 63 (35; 83)ml min
−1 por 100g respectivamente, 6 minutos después de la administración de la droga (
P<0.05 endoltelin-1 50 μg vs grupo control,
P<0.01 endotelina-1 a 100 y 200 μg versus control). Al mismo tiempo la CBS bajó en los grupos control y adrenalina de 36 (21; 41) y 39(15; 50) a 12 (2; 25) y 24 (15; 26) ml min
−1 por 100 gr, respectivamente, (
P<0.05 adrenalina versus endotelina-1 200 μg). No hubo diferencia en MBF entre los grupos de tratamiento pese a haber mayor presión de perfusión coronaria (CoPP) en el grupo de endotelina-1. El restablecimiento de circulación espontánea solo pudo ser alcanzada en los grupos de endotelina-1 de 50 μg (3 de 7; 43%) y de 100 μg (5 de 7; 71%). Este estudio sugiere que la endotelina-1 aumenta la CBF durante la RCP en forma superior a la adrenalina y aumenta el éxito de la resucitación.]]></abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>12458069</pmid><doi>10.1016/S0300-9572(02)00211-3</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0300-9572 |
| ispartof | Resuscitation, 2002-12, Vol.55 (3), p.317-327 |
| issn | 0300-9572 1873-1570 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72730186 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animals Biological and medical sciences Blood Pressure - drug effects Brain - blood supply Cardiopulmonary resuscitation Cardiopulmonary Resuscitation - methods Cerebral blood flow Coronary Circulation - drug effects Coronary perfusion pressure Double Bind Interaction Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Endotelina-1 Endothelin-1 Endothelin-1 - administration & dosage Endothelin-1 - pharmacology Endothelin-1 - therapeutic use Epinephrine - administration & dosage Epinephrine - pharmacology Epinephrine - therapeutic use Fibrilación ventricular Fibrilhação ventricular Flujo sanguı́ neo cerebral Flujo sanguı́ neo miocárdico Fluxo sanguı́ neo cerebral Fluxo sanguı́ neo miocárdico Heart Arrest - complications Heart Arrest - drug therapy Intensive care medicine Medical sciences Myocardial blood flow Presión de perfusión coronaria Pressão de perfusão coronária Prospective Studies Random Allocation Reanimación cardiopulmonar Reanimação cárdio-pulmonar Regional Blood Flow - drug effects Swine Terapia vasopresora Terapêutica vasopressora Vasoconstrictor Agents - administration & dosage Vasoconstrictor Agents - pharmacology Vasoconstrictor Agents - therapeutic use Vasopressor therapy Ventricular fibrillation Ventricular Fibrillation - complications Ventricular Fibrillation - drug therapy |
| title | Endothelin-1 elevates regional cerebral perfusion during prolonged ventricular fibrillation cardiac arrest in pigs |
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