Τίτλος:
Combination pharmacotherapy in the treatment of experimental cardiac arrest
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Study Objectives: Full recovery after cardiopulmonary resuscitation (CPR) is poor. We hypothesized that the coadministration of epinephrine, a β-blocker such as atenolol, and a calcium sensitizer such as levosimendan during CPR would improve survival and postresuscitation myocardial function. Methods: Ventricular fibrillation was induced in 60 piglets, which were left untreated for 8 minutes before attempted resuscitation. Animals were randomized into 4 groups (n = 15), to receive epinephrine (group E), epinephrine + atenolol (group E + A), epinephrine + levosimendan (group E + L) and epinephrine + atenolol + levosimendan (group E + A + L) during CPR. Electrical defibrillation was attempted 2 minutes after drug administration. Results: Five animals in group E survived for 48 hours in comparison to 8 animals in groups E + A and E + L and 12 animals in group E + A + L. Postresuscitation cardiac output was significantly better in the animals of group E + A + L. Troponin I remained significantly lower in groups E + A and E + A + L. Serum astroglial protein (S-100) and neuron-specific enolase values in group E + L and E + A + L were statistically lower than those measured in groups E and E + A during the entire observation period. The neurologic alertness score was higher in group E + A + L compared to groups E and E + A. Conclusions: The administration of a drug combination of epinephrine + atenolol + levosimendan, when given during CPR, in a pig model of cardiac arrest, results in improved 48-hour survival and improves postresuscitation cardiac function. © 2009 Elsevier Inc. All rights reserved.
Συγγραφείς:
Xanthos, T.
Bassiakou, E.
Koudouna, E.
Rokas, G.
Goulas, S.
Dontas, I.
Kouskouni, E.
Perrea, D.
Papadimitriou, L.
Περιοδικό:
The American Journal of Emergency Medicine
Λέξεις-κλειδιά:
adrenalin; atenolol; levosimendan; neuron specific enolase; placebo; protein S 100; troponin I, alertness; animal experiment; animal model; article; controlled study; defibrillation; experimental model; experimental pig; female; heart arrest; heart function; heart output; heart ventricle fibrillation; male; nonhuman; piglet; priority journal; protein blood level; resuscitation; survival time; therapy effect; treatment outcome; treatment response, Adrenergic beta-Agonists; Animals; Atenolol; Cardiotonic Agents; Disease Models, Animal; Drug Therapy, Combination; Epinephrine; Heart Arrest; Hydrazones; Lactic Acid; Phosphopyruvate Hydratase; Pyridazines; S100 Proteins; Swine; Troponin I
DOI:
10.1016/j.ajem.2008.05.004
