Addition of glucagon to adrenaline improves hemodynamics in a porcine model of prolonged ventricular fibrillation

Raffay, Violetta; Chalkias, Athanasios; Lelovas, Pavlos; Karlis, George; Koutsovasilis, Anastasios; Papalois, Αpostolos; Jevdjić, Jasna; Fiser, Z; Xanthos, Theodoros

doi:10.1016/j.ajem.2013.10.030

Cited by 5 publications

(8 citation statements)

References 34 publications

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“…Mentzelopoulos found better outcome by administering – among others - blood glucose-increasing steroids for resuscitation of in-hospital cardiac arrest [ 50 ]. In animal studies, hyperglycaemia during cardiac arrest led to greater cerebral oxygenation [ 51 ], and blood glucose-increasing glucagon administration during cardiac arrest improved survival rate, cardiac function, and neurological outcome [ 52 , 53 ]. Hyperglycaemia was associated with reduced myocardial infarction size and improved systolic function during myocardial ischaemia [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients – a retrospective Analysis

Kreutziger

Schmid

Umlauf

et al. 2018

Scand J Trauma Resusc Emerg Med

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BackgroundDeranged glucose metabolism is frequently observed in trauma patients after moderate to severe traumatic injury, but little data is available about pre-hospital blood glucose and its association with various cardiac rhythms and cardiac arrest following trauma.MethodsWe retrospectively investigated adult trauma patients treated by a nationwide helicopter emergency medical service (34 bases) between 2005 and 2013. All patients with recorded initial cardiac rhythms and blood glucose levels were enrolled. Blood glucose concentrations were categorised; descriptive and regression analyses were performed.ResultsIn total, 18,879 patients were included, of whom 185 (1.0%) patients died on scene. Patients with tachycardia (≥100/min, 7.0 ± 2.4 mmol/L p < 0.0001), pulseless ventricular tachycardia (9.8 ± 1.8, mmol/L, p = 0.008) and those with ventricular fibrillation (9.0 ± 3.2 mmol/L, p < 0.0001) had significantly higher blood glucose concentrations than did patients with normal sinus rhythm between 61 and 99/min (6.7 ± 2.1 mmol/L). In patients with low (≤2.8 mmol/L, 7/79; 8.9%, p < 0.0001) and high (> 10.0 mmol/L, 70/1271; 5.5%, p < 0.0001) blood glucose concentrations cardiac arrest was more common than in normoglycaemic patients (166/9433, 1.8%). ROSC was more frequently achieved in hyperglycaemic (> 10 mmol/L; 47/69; 68.1%) than in hypoglycaemic (≤4.2 mmol/L; 13/31; 41.9%) trauma patients (p = 0.01).ConclusionsIn adult trauma patients, pre-hospital higher blood glucose levels were related to tachycardic and shockable rhythms. Cardiac arrest was more frequently observed in hypoglycaemic and hyperglycaemic pre-hospital trauma patients. The rate of ROSC rose significantly with rising blood glucose concentration. Blood glucose measurements in addition to common vital parameters (GCS, heart rate, blood pressure, breathing frequency) may help identify patients at risk for cardiopulmonary arrest and dysrhythmias.

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Section: Discussionmentioning

confidence: 99%

Association between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients – a retrospective Analysis

Kreutziger

Schmid

Umlauf

et al. 2018

Scand J Trauma Resusc Emerg Med

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“…In brief, the animals were premedicated with intramuscular ketamine hydrochloride (10 mg/kg; Merial, Lyon, France), midazolam (0.5 mg/kg; Roche, Athens, Greece), and atropine sulphate (0.05 mg/kg; Demo, Athens, Greece) [12]. The animals were subsequently transported to the operation research facility, and intravascular access was obtained through the auricular veins.…”

Section: Animal Preparationmentioning

confidence: 99%

“…Electrocardiographic monitoring was performed using leads I, II, III, aVR, aVL, and aVF, which were connected to a monitor (Mennen Medical, Envoy; Papapostolou, Athens, Greece) [12]. The monitor electronically calculated the heart rate.…”

Section: Animal Preparationmentioning

confidence: 99%

“…CO was measured as the product of time-velocity integral of Doppler transaortic flow, the diameter of the aortic valve, and heart rate; SVR was calculated using the formula SVR=(MAP-CVP)/CO×80, as previously described [10,11]. Coronary perfusion pressure (CPP) was electronically calculated as the difference between minimal DAP and the simultaneously measured right atrial diastolic pressure [12]. Arterial blood gases were measured on a blood-gas analyzer (IRMA SL Blood Analysis System, Part 436301; Diametrics Medical Inc, Roseville, MN, USA; pH, pO2, pCO2).…”

Section: Animal Preparationmentioning

confidence: 99%

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Measurement of mean systemic filling pressure after severe hemorrhagic shock in swine anesthetized with propofol-based total intravenous anesthesia: implications for vasopressor-free resuscitation

et al. 2020

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Background:Mean systemic filling pressure (Pmsf) is a quantitative measurement of a patient's volume status and represents the tone of the venous reservoir. The aim of this study was to estimate Pmsf after severe hemorrhagic shock and cardiac arrest in swine anesthetized with propofol-based total intravenous anesthesia, as well as to evaluate Pmsf's association with vasopressor-free resuscitation. Methods: Ten healthy Landrace/Large-White piglets aged 10-12 weeks with average weight 20 ± 1 kg were used in this study. The protocol was divided into four distinct phases: stabilization, hemorrhagic, cardiac arrest, and resuscitation phases. We measured Pmsf at 5-7.5 seconds after the onset of cardiac arrest and then every 10 seconds until 1 minute postcardiac arrest. During resuscitation, lactated Ringers was infused at a rate that aimed for a mean right atrial pressure of ≤ 4 mm Hg. No vasopressors were used. Results: The mean volume of blood removed was 860 ± 20 ml (blood loss, ~61%) and the bleeding time was 43.2 ± 2 minutes while all animals developed pulseless electrical activity. Mean Pmsf was 4.09 ± 1.22 mm Hg, and no significant differences in Pmsf were found until 1 minute postcardiac arrest (4.20±0.22 mm Hg at 5-7.5 seconds and 3.72±0.23 mm Hg at 55-57.5 seconds; P=0.102). All animals achieved return of spontaneous circulation (ROSC), with mean time to ROSC being 6.1 ±1.7 minutes and mean administered volume being 394 ±20 ml. Conclusions: For the first time, Pmsf was estimated after severe hemorrhagic shock. In this study, Pmsf remained stable during the first minute post-arrest. All animals achieved ROSC with goal-directed fluid resuscitation and no vasopressors.

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“…EL 09 BIO 03) one week before experimentation. Prior to the experimental procedure, the animals were fasted overnight but had free access to water [8]. All animals were examined by a veterinarian on the day of the experimentation and were found healthy.…”

Section: Animal Preparationmentioning

confidence: 99%

Assessment of Post-Resuscitation Intestinal Injury and Timing of Bacterial Translocation in Swine Anaesthetized With Propofol-Based Total Intravenous Anaesthesia

Tassopoulos

Chalkias

Papalois

et al. 2020

Cureus

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Introduction and objectives Bacterial translocation (BT) is the passage of viable bacteria or endotoxins from the gastrointestinal lumen to extra-luminal tissues and is usually observed after intestinal ischaemia-reperfusion injury. The aim of this study was to investigate post-resuscitation BT after cardiac arrest and resuscitation in a swine anaesthetized with propofol-based total intravenous anaesthesia.

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Addition of glucagon to adrenaline improves hemodynamics in a porcine model of prolonged ventricular fibrillation

Cited by 5 publications

References 34 publications

Association between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients – a retrospective Analysis

Association between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients – a retrospective Analysis

Measurement of mean systemic filling pressure after severe hemorrhagic shock in swine anesthetized with propofol-based total intravenous anesthesia: implications for vasopressor-free resuscitation

Assessment of Post-Resuscitation Intestinal Injury and Timing of Bacterial Translocation in Swine Anaesthetized With Propofol-Based Total Intravenous Anaesthesia

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