Summary:
Purpose: The purpose of the experiment was to compare the effects of nifekalant
and amiodarone on the return of spontaneous circulation (ROSC), survival, as
well as on the hemodynamic parameters in a swine model of prolonged ventricular
fibrillation (VF).
Methods: After 8 min of untreated VF, bolus doses of epinephrine (adrenaline)
and either nifekalant, or amiodarone, or saline (n = 10 per group), were
administered after randomization. Cardiopulmonary resuscitation (CPR) was
commenced immediately after drug administration and defibrillation was
attempted 2 min later. CPR was resumed for another 2 min after each
defibrillation attempt and the same dose of adrenaline was given every 4th
minute during CPR.
Results: 48h survival was significantly higher with nifekalant compared to
amiodarone (p<0.001) and saline (p=0.02), (9/10 vs. 0/10 vs. 3/10,
respectively). Systolic aortic pressure, diastolic aortic pressure and coronary
perfusion pressure were significantly higher with nifekalant during CPR and
immediate post-resuscitation period (p<0.05). The animals in the amiodarone
group had a slower heart rate at the 1st and 45th min post-ROSC (p<0.001 and
p=0.006, respectively). The number of electric shocks required for terminating
VF, time to ROSC and adrenaline dose were significantly higher with amiodarone
compared to nifekalant (p<0.001).
Conclusions: Nifekalant showed a more favorable hemodynamic profile and
improved survival compared to amiodarone and saline in this swine model.
Keywords:
Cardiac arrest, Resuscitation, Ventricular fibrillation, Amiodarone, Nifekalant
